• Title/Summary/Keyword: talus

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The Result of Autologous Osteochondral Grafting for the Osteochondral Lesion of the Talus (거골의 골연골 병변에 대한 자가 골연골 이식술의 결과)

  • Ahn, Young-Joon;Hahn, Sung-Ho;Yang, Bo-Kyu;Yi, Seung-Rim;Yoo, Jae-Ho;Chung, Shun-Wook;Bin, Sung-Woo;Zoo, Min-Hong;Kim, Seong-Wan
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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    • pp.48-55
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    • 2006
  • Purpose: The purpose of this study is to assess the results of the autologous osteochondral grafting for the osteochondral lesion of the talus. Materials and Methods: This study included 21 patient who had been treated with the open autologous osteochondral grafting between December, 1999 and December 2003. We treated the patients with autologous osteochondral grafting method who had the lesion of stage II or medial lesion of stage III without improvement for at least 6 months, the medial lesion of stage IV, the lateral lesion of stage III, IV by Berndt and Harty's classification or who had not improved with previous operation. The average duration of follow up was 26 (12-56) months. 6 patients had been treated with the previous operation that 3 patients with drilling, 3 patients excision, curettage and drilling. Results: The average AOFAS Ankle/Hindfoot score was 92.7 points and no patient had a limitation of the daily activities due to pain or abnormal function. Postoperative radiography showed good joint congruency and postoperative MRI good incorporation of the graft. The average Lysholm knee score was 96 points and only two patients had mild knee pain during severe exertion. Conclusion: The autologous osteochondral grafting is the useful operative method when the lesion is advanced stage or when previous operative treatment has failed.

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Arthroscopic Assessment of Potential Intra-articular Ankle Injury in Treatment of Ankle Fracture (족관절 골절의 치료에 있어 잠재적 관절 내 손상의 관절경적 평가)

  • Kim, Jung-Han;Gwak, Heui-Chul;Lee, Hyeong-Joo
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.4
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    • pp.151-155
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    • 2015
  • Purpose: The purpose of this study was to analyze the frequency and patterns of intra-articular lesions detected during ankle fracture surgery using ankle arthroscopy. Materials and Methods: Thirty patients (31 ankles) who underwent open reduction and internal fixation combined with ankle arthroscopy for acute ankle fracture at Inje University Busan Paik Hospital from June 2011 to September 2013 were evaluated. The ankle fractures were classified according to the AO/OTA (AO Foundation and Orthopaedic Trauma Association) classification and the intraarticular injuries were identified by ankle arthroscopy. Osteochondral lesions of the talus were divided into nine subtypes based on their locations, and the ligament injuries were classified according to avulsion fracture and rupture. Results: Using arthroscopy, abnormality in the distal tibiofibular ligament was found in 21 cases and osteochondral lesions and defects of the talus larger than 5 mm were detected in 26 cases. Among ligament injuries, anterior inferior tibio-fibular ligament injury was found in 14 cases, posterior inferior tibio-fibular ligament injury was found in two cases, deep deltoid ligament injury was found in three cases, and deep transverse tibio-fibular ligament injury was found in five cases. The locations of the osteochondral lesions were on the antero-lateral, antero-medial, centro-medial, centro-central, centro-lateral, and postero-lateral talus in 11, one, two, one, two, and nine cases, respectively. Conclusion: With early diagnosis and treatment arthroscopy performed at the time of intra-articular fracture surgery is expected to result in a good outcome.

Analysis of Clinical Outcomes in Ankle Arthroscopy Focusing on Prognostic Factors and Usefulness of High Portals (Outcomes in 169 Consecutive patients) (족근관절 관절경의 예후 인자와 상방 입구의 유용성에 대한 임상적 분석 (169례 보고))

  • Kim, Sung-Jae;Kim, Sung-Hun;Kang, Eung-Shick;Lee, Jin-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.5 no.2
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    • pp.103-111
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    • 2001
  • Purpose: The purpose of this study was to evaluate prognostic factors of ankle arthroscopy and the effectiveness of high anteromedial and anterolateral portals in diagnosis and treatment for various disease entities. Materials and Methods: The results of ankle arthroscopy were evaluated between March 1992 and January 2000 by one surgeon. Total 169 patients who were followed for a minimum of 12 months, were included in this study. Using high anteromedial and high anterolateral portals, all procedures were done with accessory portals if necessary. A functional evaluation was performed using the Karlsson score and questionnaire subjectively. Results: Fifty-six synovial impingement, 48 osteochondral lesion on talus, 10 impingement exostosis, 8 loose body, 27 osteoarthritis and chondromalacia, 10 postfracture fibrosis, 3 lateral plica, and 1 pigmented villonodular synivitis(PVNS) among 169 patients were diagnosed. Patients with the former four groups had satisfactory results and the latter four groups had not. Remaining 6 patients underwent arthroscopic arthrodesis, and 5 had satisfactory results. Conclusion: Using high anteromedial and anterolateral portals, we could get better visualization of talar dome and posterior chamber of ankle. For better clinical results, in ankle arthroscopy, not only operative skill but also proper indications are important. In case of synovial impingement after trauma, arthroscopy should be considered within one year after initial trauma. There were little correlation between the radiographic findings and arthroscopic findings of articular cartilage in osteochondral lesion of talus, and it is better to determine treatment modality based on the arthroscopic or MRI findings. Osteochondral lesions were treated successfully only when they were traumatically induced and localized without diffuse chondromalacia of talus and tibia.

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Micro-Structural Profiles of Trabecular Bone at the Ankle Joint (족관절 해면골의 미세 구조 분석)

  • Kim, Hyon-Jeong;An, Tae-Sun;Baek, Myong-Hyun;Choi, Mun-Kwon;Won, Ye-Yeon
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.2
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    • pp.157-160
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    • 2004
  • Purpose: This study aimed to investigate and compare the micro-structural profiles of trabecular bone from different facets at the ankle joint. Materials and Methods: In a fresh cadaver ankle, four cored 10 mm of diameter cylindrical specimens of trabecular bone were harvested from the distal tibia, the talar dome, the medial malleolus, and the lateral malleolus. Using a micro-computed tomography, two-dimensional and three-dimensional micro-structural indices of the trabecular bone were analyzed. Results: Each specimen from the tibia, talus, medial malleolus, and the lateral malleolus showed unique micro-structural pattern. Tibia versus talus, the talus was seen a higher bone volume fraction and a wider supporting zone subchondrally whereas the tibia was seen a relatively lower bone volume fraction and a much narrower supporting zone subchondrally. Lateral malleolus versus medial malleolus, the lateral malleolus was seen the thicker but sparse trabeculae pattern whereas the medial malleolus was seen the thinner but more compact trabecular pattern. Conclusion: Each four locations from the different facet at the ankle joint have distinct own micro-structural patterns of the trabecular bone, suggesting different mechanical properties.

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Comparison of Radiologic Parameters between Weight Bearing Affected Single Ankle Anteroposterior View and both Ankle Anteroposterior View in Ankle Osteoarthritis (족관절 관절염이 있는 환자에서 체중 부하상태의 양측 족관절과 환측 족관절 전후면 방사선 사진의 방사선학적 측정치의 비교)

  • Kim, Jung-Rae;Lee, Woo-Chun
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.3
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    • pp.159-164
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    • 2011
  • Purpose: This study was performed to analyze the results of radiologic parameters between weight bearing affected single ankle anteroposterior (AP) view and both ankle AP view in ankle osteoarthritis (OA). Materials and Methods: Between January 2009 and August 2010, 41 patients (50 ankles) who visited our institution to treat ankle OA were reviewed retrospectively. In radiographic assessment, weight bearing affected single ankle AP view and both ankle AP view were checked, and measured tibial anterior surface angle (TAS), tibial medial malleolar angle (TMM), talar tilting angle (TT), maximum and minimun joint space width (JSW) of ankle, width between articular surface of medial malleolar and medial articular surface of talus as radiologic parameters. Results: On weight bearing both ankle AP view, TAS was $85.4{\pm}4.1^{\circ}$, TMM was $33.1{\pm}9^{\circ}$, TT was $5.4{\pm}6.1^{\circ}$, maximum JSW was $3.2{\pm}2.7$ mm, minimum JSW was $1.1{\pm}1.3$ mm, width between articular surface of medial malleolar and medial articular surface of talus was $1.8{\pm}1.8$ mm and on weight bearing affected ankle AP view, TAS was $85.3{\pm}3.9^{\circ}$, TMM was $34.3{\pm}10.9^{\circ}$, TT was $5.4{\pm}6.5^{\circ}$, maximum JSW was $3.2{\pm}2.7$ mm, minimum JSW was $1.1{\pm}1.3$ mm, width between articular surface of medial malleolar and medial articular surface of talus was $1.6{\pm}1.7$ mm. Conclusion: There is no statistical significance in radiologic parameters between weight-bearing affected single ankle AP view and both ankle AP view in ankle OA.

Analysis on the Characteristics of the Landslide in Maeri (I) - With a Special Reference on Geo-Topographical Characteristics - (매리 땅밀림형 산사태(山沙汰)의 발생특성(發生特性)에 관한 분석(分析) (I) - 지형(地形) 및 지질특성(地質特性)을 중심(中心)으로 -)

  • Park, Jae-Hyeon;Choi, Kyung;Bae, Jong Soon;Ma, Ho-Seop;Lee, Jong-Hak
    • Journal of Korean Society of Forest Science
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    • v.94 no.3 s.160
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    • pp.129-134
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    • 2005
  • Ths study was carried out to understand the geo-topographical characteristics of the landslide area (1.5 ha) in Maeri, Sangdong-myeon, Gimhaesi, Gyeongsangnam-do. The bedrock of the landslide area was diollites and the area in and around the upper slope with the scattered talus was composed of Masanam originated from Igneous rocks. The landslide occurred in 19th of April, 2004 and the amount of rainfall for 3 days before the landslide was 74mm. The landslide by land creeping in this area was mainly attributed to geo-topographical characteristics such as well developed colluvial and/or weathered soils, and land cutting in lower slope, although the landslide could be affected by the rainfall. The type of the landslide can be classified into the land creeping by concave colluvial soils.

Second-look Arthroscopy after Surgical Treatment for Osteochondral Lesion of Talus - Comparison of Mosaicplasty with Microfracture - (거골 골연골 병변의 수술적 치료 후 이차 관절경술 -자가 골연골 이식술과 미세 골절술의 결과 비교-)

  • Choi, Jin;Lee, Keun-Bae;Cho, Seong-Beom;Jung, Sung-Taek;Park, Gi-Heon
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.2
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    • pp.133-139
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    • 2006
  • Purpose: To evaluate the results of mosaicplasty and microfracture after surgical treatments for symptomatic osteochondral lesion of talus (OLT) by second-look arthroscopy. Materials and Methods: 7 cases of mosaicplasty and 7 cases of microfracture were reviewed who undertook second-look arthroscopy at 6 months or one year after undertaking mosaicplasty or microfracture for OLT between December 2004 and October 2005. The mean age at first operation was 43.6 years (Range, 20-59) (Mosaicplasty; 43.9 years, Microfracture; 43.4 years). The mean size of cartilage defect was $15.0{\times}7.7\;mm$ in mosaicplasty and $7.1{\times}6.6\;mm$ in microfracture. Clinical outcomes were evaluated by Freiburg ankle score. Cartilage healing state was evaluated by Insall's classification for chondromalasia during second-look arthroscopy. Results: By the Freiburg ankle score, 9 ankles (6 in mosaicplasty, 3 in microfracture) had excellent and 5 (1 in mosaicplasty, 4 in microfracture) had good results at the times of second-look arthroscopy. By Insall's classification, consistency of the osteochondral grafts and congruity between grafts and native cartilage (Grade I) were shown in 9 (6 ankles in mosaicplasty, 3 ankles in microfracture), a fissuring (Grade II) in one ankle of mosaicplasty, a fasciculation (Grade III) in one ankle of microfracture, and partial exposure of subchondral bone (Grade IV) in 3 ankles of microfractures. Conclusion: Mosaicplasty was more excellent in consistency and hardness of cartilage than microfracture. In some cases of microfracture, cartilage healing was incomplete at 6 months postoperatively, so second-look arthroscopy is necessary to identify. If incomplete cartilage healing was shown, additional procedure such as microfracture or mosaicplasty was needed.

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The Complication of the Talar Neck Fracture (거골 경부 골절의 합병증)

  • Seong, Byeong-Yeon;Park, Wan-Soo;Lee, Seung-Ki;Park, Chan-Ji;Kim, Dong-Won
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.1
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    • pp.119-125
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    • 2003
  • Purpose: The purpose of this study fracture. Materials and Methods: The clinical and radiological analysis were performed on 19 cases of the talus neck fractures who had been treated with conservative treatment or variable methods of operative treatment. Each cases followed up more than 1 year and 6 months from May 1989 to June 2001. The clinical results were analyzed according to the age, cause of injury, fracture type of Hawkins classification, associated soft tissue injury, method of treatments, complications, and Hawkins scoring system. Results: According to Hawkins classification, type I was 6 cases(32%), type II was 5 cases(26%), typeIII was 7 cases(37%), and typeIV was 1 case(5%). In all cases, complete bony union was obtained. According to the Hawkins scoring system, 8 cases(42%) were excellent and good. Avascular necrosis was 4 cases(25%). Traumatic arthritis was 10 cases which were occurred in type II, III and IV. An ankle fusion was 1 case. Conclusion: In talar neck fractures, non-displaced fracture treated by the cast immobilization and displaced fracture treated by early open reduction and internal fixation were expected good results. The complications were 77% of traumatic arthritis and 31% of avascular necrosis in type II, III and IV. We should preoperatively explain to the patient for high complication rates of traumatic osteoarthritis and avascular necrosis in the talus neck fractures.

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