The Significance of MRI in Process Change of Osteochondral Lesion of Talus

Category: Sports Introduction/Purpose: To evalute if the MRI Signals can be the predictor of osteochondral lesion of talus Methods: From Jul. 2012 to Oct. 2014, 3.0 T MRI scanning was performed in 20 cases of ankle sprain. MRI scanning was performed every 3 monthes and the followed-up time of each case was 12 months. The signal of cartilage, subchondral bone and marrow edema were recorded and analyzed comparatively. Results: The signal of marrow edema in talus body of 14 cases were decreased step by step and disappeared eventually. The time from injury to the marrow edema disappear was more than 9 months. 4 cases became III° osteochondral lesion and 2 cases have subchondral bone cyst formation. Conclusion: The reason of OLT and pain were under discussion. After sprain, what changes occured in the talus body and cartilage were under debate. How the subchondral bone cyst formation was unknown. Continuous MRI scanning may have some value in evaluation of the OLT. From the results of our study, we can see that the edema signal in most case can disappear in about 9 months. The OLT and cyst formation may resulted from violent force and no-standard conservative treatment. MRI scanning can help the surgeon decide when to perform operation and choice the operative procedure.

Management of Hepple Stage V Osteochondral Lesion of Talus with Platelet-Rich Plasma (PRP) Scaffold

Category: Ankle Introduction/Purpose: There is no consensus on treatment or prognosis for Hepple stage V Osteochondral lesion of talus (OLTs), especially for lesion more than 1.5 cm2. This research was to investigate surgical techniques and clinical outcomes of platelet-rich plasma (PRP) scaffold for Hepple stage V OLTs. Methods: 14 patients were treated by cancellous bone graft with PRP gel scaffold between 2013 and 2015 with average age of 38.9 years old and mean set of 23.5 months. Ankle X-ray and MRI were obtained at the final follow-up for evaluation. Functional outcomes were scored by the Visual Analog Scale (VAS) score, American Orthopaedics Foot and Ankle Society (AOFAS) ankle- hindfoot score and Short Form (36) Survey score (SF-36). Range of motion (ROM) of ankle joint and complications were also recorded. Results: 13 patients got the final follow-up with a mean duration of 18 months. MRI showed complete regeneration of subchondral bone and cartilage in all patients. The post-operative VAS, AOFAS ankle-hindfoot score and SF-36 score improved significantly (P<0.0001) without obvious complications. Conclusion: We suggest that for the patients of Hepple stage V OLTs, cancellous bone graft with PRP scaffold may be a safe and effective treatment.