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The anterior approach for the treatment of posterior osteochondral lesions of the talus: comparison of different surgical techniques

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An Erratum to this article was published on 12 September 2006

Abstract

Introduction: Most of all osteochondral talar lesions are located in the middle and posterior area of the talar surface. Malleolar osteotomy is often used to access the defect but may be associated with malunion or secondary osteoarthritis. We present an alternative approach to the talus with temporary removal and replacement of a tibial bone block and compare it with other anterior approaches described in the literature. Patients and methods: Thirteen patients (5 males, 8 females) with an average age of 27.2 years and an osteochondral talar lesion were included in our study. All patients were previously operated on the same ankle. Ten lesions were caused by a sports injury. The average follow up was 45 months. The patients were evaluated before and after surgery using the ankle and hindfood score (AOFAS). For the analyses baseline clinical data were compared with follow up data using the Wilcoxon test. Results: The overall improvement between the preoperative and postoperative AOFAS scores was an average of 34.9 points (P=0.0002). No complications occurred at the site of the tibial bone block and the donor site at the talus. There were no patients with recurrence or an ankle osteoarthrosis in the follow up period. Conclusion: The removal of a tibial bone block and its subsequent replacement is a useful technique to access osteochondral talar lesions for osteochondral transplantation for which arthroscopic interventions have failed. The results are comparable to other anterior approaches described in the literature.

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Acknowledgements

This project was carried out without any financial support. This manuscript does not contain information about medical devices. The study complies with the current laws of the country in which it was performed.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Albert Ludwig University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany

    Peter Cornelius Kreuz, Matthias Steinwachs, Max Edlich, Tim Kaiser, Jörg Mika, Andreas Lahm & Norbert Südkamp

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  1. Peter Cornelius Kreuz
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  2. Matthias Steinwachs
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  3. Max Edlich
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  4. Tim Kaiser
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  7. Norbert Südkamp
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Correspondence to Peter Cornelius Kreuz.

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An erratum to this article can be found at http://dx.doi.org/10.1007/s00402-006-0220-8

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Kreuz, P.C., Steinwachs, M., Edlich, M. et al. The anterior approach for the treatment of posterior osteochondral lesions of the talus: comparison of different surgical techniques. Arch Orthop Trauma Surg 126, 241–246 (2006). https://doi.org/10.1007/s00402-005-0058-5

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  • DOI: https://doi.org/10.1007/s00402-005-0058-5

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