Zusammenfassung
Die osteochondralen Läsionen des Talus werden meistens erst im chronischen Stadium erkannt. Die operative Behandlung der osteochondralen Läsionen basiert somit in erster Linie auf der Defektdeckung, sei es durch Bildung eines Ersatzknorpels nach Exzision und Mikrofrakturierung oder durch hyaline Knorpelreparaturverfahren wie die autologe Knorpel-Knochen-Transplantation oder die autologe Chondrozytentransplantation. Basierend auf der heutigen Literatur erläutert dieser Beitrag die präoperative Diagnostik und die Indikationsstellung zur operativen Therapie osteochondraler Defekte des Talus. Es wird besonders auf die sprunggelenkspezifischen Operationstechniken zur Behandlung von Knorpelschäden eingegangen.
Abstract
Delayed diagnosis of osteochondral lesions of the talus is common; acute osteochondral injuries to the talar dome frequently go unrecognized. While acute lesions may be repaired, typically the focus of operative treatment for osteochondral lesions is on: (a) débridement and drilling/microfracture (leading to filling of the defect with fibrocartilage) or (b) salvage procedures, including osteochondral autograft transfer system and autologous chondrocyte implantation (potentially leading to resurfacing of the defect with hyaline cartilage). In this article, we review current trends in preoperative assessment, defining indications and surgical management of osteochondral lesions of the talus.
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Merian, M., Easley, M. Diagnostik und Therapie osteochondraler Läsionen des Talus. Orthopäde 37, 204–211 (2008). https://doi.org/10.1007/s00132-008-1219-3
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DOI: https://doi.org/10.1007/s00132-008-1219-3