Chondral and Osteochondral Lesions

Abstract

Symptomatic focal cartilage lesions between 1–2 cm² in size, ICRS grade 3–4. Strict indication includes corresponding cartilage lesions.

Specific contraindications: osteoarthritis, osteonecrosis, osteochondral defects (relative).

Induction of regenerative cartilage tissue formation through releasing mesenchymal stem cells after penetration of the subchondral lamella.

• Symptom specific history: pain character, limitation of movement, locking, instability, trauma

• Symptom specific examination: Malalignment, foot deformity, tenderness, pain on motion, range of motion, crepitation, locking, and instability.

Examination and documentation of peripheral neurological and vascular condition (particularly the superficial peroneal nerve, intermediate and medial dorsal cutaneous nerves, peroneal nerve, tibial nerve, dorsalis pedis, anterior and posterior tibial arteries.

• Conventional X-ray of the ankle in 2 planes (AP in 18° of internal rotation [Mortise-view] and lateral) for evaluation of deformities, calcification, necrosis, cysts and arthritic changes

• MRI to assess the extension of the cartilage damage, subchondral cysts and associated reactions, osteoarthritic changes and the presence of loose bodies

• CT with intraarticular contrast agent as an alternative to MRI with a higher sensitivity to cartilage defects e. g. presence of metallic implants

• Special radiological studies could be helpful (e. g. MRI T2-Mapping)