Acute and recurrent ankle sprains and other trauma to the ankle joint are common injuries in soccer and can be accompanied by or result in osteochondral lesions of the ankle joint, majorly of the talus. Conservative treatment frequently fails. Several operative treatment techniques exist; however, the choice of the right procedure is difficult due to lack of literature with a high level of evidence. We present our treatment method for acute and chronic ankle osteochondral lesions with cystic formation approached by a new surgical technique combining bone plasty and a collagen matrix (autologous matrix-induced chondrogenesis).
Levels of Evidence: Therapeutic, Level IV: Case series
TagaIShinoKInoueMNakataKMaedaA. Articular cartilage lesions in ankles with lateral ligament injury. An arthroscopic study. Am J Sports Med. 1993;21:120-126.
2.
HintermannBBossASchaferD. Arthroscopic findings in patients with chronic ankle instability. Am J Sports Med. 2002;30:402-409.
3.
SteadmanJRRodkeyWGRodrigoJJ. Microfracture: surgical technique and rehabilitation to treat chondral defects. Clin Orthop Relat Res. 2001;(391 suppl):S362-S369.
4.
HangodyL. The mosaicplasty technique for osteochondral lesions of the talus. Foot Ankle Clin. 2003;8:259-273.
5.
HangodyLKishGMódisL. Mosaicplasty for the treatment of osteochondritis dissecans of the talus: two to seven year results in 36 patients. Foot Ankle Int. 2001;22:552-558.
6.
ImhoffABPaulJOttingerB. Osteochondral transplantation of the talus: long-term clinical and magnetic resonance imaging evaluation. Am J Sports Med. 2011;39:1487-1493.
7.
RongaMGrassiFAMontoliCBulgheroniPGenoveseECherubinoP. Treatment of deep cartilage defects of the ankle with matrix-induced autologous chondrocyte implantation (MACI). Foot Ankle Surg. 2005;11:29-33.
8.
GianniniSBudaRGrigoloBVanniniF. Autologous chondrocyte transplantation in osteochondral lesions of the ankle joint. Foot Ankle Int. 2001;22:513-517.
9.
RaikinSM. Fresh osteochondral allografts for large-volume cystic osteochondral defects of the talus. J Bone Joint Surg Am. 2009;91:2818-2826.
10.
GianniniSBudaRFaldiniC. Surgical treatment of osteochondral lesions of the talus in young active patients. J Bone Joint Surg Am. 2005;87(suppl 2):28-41.
11.
SchneiderTEKaraikudiS. Matrix-induced autologous chondrocyte implantation (MACI) grafting for osteochondral lesions of the talus. Foot Ankle Int. 2009;30:810-814.
12.
ValderrabanoVMiskaMLeumannAWiewiorskiM. Reconstruction of osteochondral lesions of the talus with autologous spongiosa grafts and autologous matrix-induced chondrogenesis. Am J Sports Med. 2013;41:519-527.
WiewiorskiMLeumannABuettnerOPagenstertGHorisbergerMValderrabanoV. Autologous matrix-induced chondrogenesis aided reconstruction of a large focal osteochondral lesion of the talus. Arch Orthop Trauma Surg. 2011;131:293-296.
15.
WeberBG. Die Verletzungen des oberen Sprunggelenkes. Bern-Stuttgart: Huber; 1966.
16.
HamiltonWGThompsonFMSnowSW. The modified Brostrom procedure for lateral ankle instability. Foot Ankle. 1993;14:1-7.
17.
CarlssonAM. Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale. Pain. 1983;16:87-101.
18.
KitaokaHBAlexanderIJAdelaarRSNunleyJAMyersonMSSandersM. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int. 1994;15:349-353.
AurichMBediHSSmithPJ. Arthroscopic treatment of osteochondral lesions of the ankle with matrix-associated chondrocyte implantation: early clinical and magnetic resonance imaging results. Am J Sports Med. 2011;39:311-319.
21.
FerkelRDZanottiRMKomendaGA. Arthroscopic treatment of chronic osteochondral lesions of the talus: long-term results. Am J Sports Med. 2008;36:1750-1762.
22.
GautierEKolkerDJakobRP. Treatment of cartilage defects of the talus by autologous osteochondral grafts. J Bone Joint Surg Br. 2002;84:237-244.
23.
ValderrabanoVLeumannAFriggAPagenstertGWiewiorskiM. Autologous matrix-induced chondrogenesis-aided repair of osteochondral lesions of the talus. Techniques in Foot & Ankle Surgery. 2011;10:159-162.
24.
WiewiorskiMMiskaMNicolasGValderrabanoV. Revision of failed osteochondral autologous transplantation procedure for chronic talus osteochondral lesion with iliac crest graft and autologous matrix-induced chondrogenesis: a case report. Foot Ankle Spec. 2012;5:115-120.
25.
BarkSRiepenhofHGilleJ. AMIC cartilage repair in a professional soccer player. Case Rep Orthop. 2012;2012:364342.
26.
WiewiorskiMBargAValderrabanoV. Chondral and osteochondral reconstruction of local ankle degeneration. Foot Ankle Clin. 2013;18:543-554.
