Cartilage repair techniques of the talus: An update  

作　　者：Mike H Baums Wolfgang Schultz Tanja Kostuj Hans-Michael Klinger 

机构地区：[1]University of G?ttingen Medical Centre,Aukamm Klinik Gmb H,D-65191 Wiesbaden,Germany [2]Department of Orthopaedic Surgery,University of G?ttingen Medical Centre (UMG),Georg-August-University,D-37099 G?ttingen,Germany [3]Institute of Medical Biometrics and Epidemiology,University of Witten/Herdecke,D-58448 Witten,Germany

出　　处：《World Journal of Orthopedics》2014年第3期171-179,共9页世界骨科杂志（英文版）

摘　　要：Symptomatic chondral or osteochondral defects of the talus reduce the quality of life of many patients.Although their pathomechanism is well understood,it is well known that different aetiologic factors play a role in their origin.Additionally,it is well recognised that the talar articular cartilage strongly differs from that in the knee.Despite this fact,many recommendations for the management of talar cartilage defects are based on approaches that were developed for the knee.Conservative treatment seems to work best in paediatric and adolescent patients with osteochondritis dissecans.However,depending on the size of the lesions,surgical approaches are necessary to treat many of these defects.Bone marrow stimulation techniques may achieve good results in small lesions.Large lesions may be treated by open procedures such as osteochondral autograft transfer or allograft transplantation.Autologous chondrocyte transplantation,as a restorative procedure,is well investigated in the knee and has been applied in the talus with increasing popularity and promising results but the evidence to date is poor.The goals of the current article are to summarise the different options for treating chondral and osteochondral defects of the talus and review the available literature.Symptomatic chondral or osteochondral defects of the talus reduce the quality of life of many patients. Although their pathomechanism is well understood, it is well known that different aetiologic factors play a role in their origin. Additionally, it is well recognised that the talar articular cartilage strongly differs from that in the knee. Despite this fact, many recommendations for the management of talar cartilage defects are based on approaches that were developed for the knee. Conservative treatment seems to work best in paediatric and adolescent patients with osteochondritis dissecans. However, depending on the size of the lesions, surgical approaches are necessary to treat many of these defects. Bone marrow stimulation techniques may achieve good results in small lesions. Large lesions may be treated by open procedures such as osteochondral autograft transfer or allograft transplantation. Autologous chondrocyte transplantation, as a restorative procedure,is well investigated in the knee and has been applied in the talus with increasing popularity and promising results but the evidence to date is poor. The goals of the current article are to summarise the different options for treating chondral and osteochondral defects of the talus and review the available literature.

关 键 词：Cartilage defect TALUS Repair TECHNIQUES ARTHROSCOPY MARROW stimulation MOSAICPLASTY Autologous CHONDROCYTE implantation 

分 类 号：R687.3[医药卫生—骨科学]