Advanced Learning Pathway: Osteochondral Defects – Treatment Options

Learning Objectives of this Pathway:

• Describe the role of OCD morphology for decision making and surgical approach
• Describe various treatment options for OCDs
• Understand the role and limitations of ankle arthroscopy in management of OCDs
• Describe the arthroscopic OCD classification and clinical relevance in surgical decision making
• Describe the difference of non-tissue vs. tissue transplantation procedures
• Describe advantages and disadvantages utilizing arthroscopy vs. open arthrotomy

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Day 1: Morphology and Decision Making

Clinical Sessions

• Osteochondral Lesions of the Talus: Does Size of Repair Matter?
• Does Size Matter: What the Evidence Really Suggests
• Location, Location, Location: Outcomes Based on Location

Osteochondral Lesions of the Talar Dome 

E-Book Chapters:
Trauma eBook
Ch 9: Osteochondral Fractures and Injuries of the Talus

Outside Journal Articles:

• Subchondral Pathology: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle
• Osteochondral Lesions of the Talus: Predictors of Clinical Outcome
• Return to Sports After Surgical Treatment of Osteochondral Defects of the Talus: A Systematic Review of 2347 Cases

Day 2​​​: Role of Arthroscopy & Microfracture

Clinical Sessions

• Talar Microfracture and Chondral Resurfacing
• Is Microfracture the Gold Standard?

Arthroscopic Microfracture of OLTs

Podcasts:
None

E-Book Chapters:
Arthroscopy eBook
Ch 6: Arthroscopic Treatments of Ankle Osteochondral Lesions

JFAS Articles:

• Arthroscopic Bone Grafting of Talar Bone Cyst Using Posterior Ankle Arthroscopy
• Arthroscopic Treatment of Osteochondral Lesions of the Talus Utilizing Juvenile Particulated Cartilage Allograft: A Case Series
• Arthroscopic Treatment of Osteochondral Lesions of the Talus Using Juvenile Articular Cartilage Allograft and Autologous Bone Marrow Aspirate Concentration
• Fixation of a Posteromedial Osteochondral Lesion of the Talus Using a Three-Portal Posterior Arthroscopic Technique

Day 3​​​: OATs & Allografts

Clinical Sessions:

• OATS and Fresh Osteochondral Allograft Transplantation: When Do They Work?
• Allografts for OLT

Surgical Techniques:
Treatment of Osteochondral Defects

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None

Journal Articles:

• Osteochondral Allograft Transplantation Surgery for Osteochondral Lesions of the Talus in Athletes
• Vascularized Medial Femoral Condyle Autografts for Osteochondral Lesions of the Talus: A Preliminary Prospective Randomized Controlled Trial
• Complications of En Bloc Osteochondral Talar Allografts and Treatment of Failures: Literature Review and Case Report

The Role of Demineralized Allograft Subchondral Bone in the Treatment of Talar Cystic OCD Lesions That Have Failed Microfracture

Day 4​​​: Emerging Techniques

Clinical Sessions:

• Autologous Chondrocyte Implantation: Where are We with Cost and Outcomes?
  
• Importance of Emerging Techniques

None

None

JFAS Articles:

• Treatment of a Focal Articular Cartilage Defect of the Talus with Polymer-Based Autologous Chondrocyte Implantation: A 12-Year Follow-Up Period
• Autologous Chondrocyte Implantation for Talar Osteochondral Lesions: Comparison Between 5-Year Follow-Up Magnetic Resonance Imaging Findings and 7-Year Follow-Up Clinical Results
• Functional Medium-Term Results After Autologous Matrix-Induced Chondrogenesis for Osteochondral Lesions of the Talus: A 5-Year Prospective Cohort Study
• Predictors of Osteochondral Lesions of the Talus in Patients Undergoing Broström-Gould Ankle Ligament Reconstruction

Outside Journal Articles:

• Arthroscopic Autologous Chondrocyte Implantation in the Ankle Joint
• Tissue Bioengineering in the Treatment of Osteochondritis Dissecans of the Talus in Children With Open Physis: Preliminary Results
• Management of Hepple Stage V Osteochondral Lesion of the Talus with a Platelet-Rich Plasma Scaffold