J Bone Joint Surg Am. [ 11 , 12 , 9 ] The shortcomings of CT are applied radiation, especially in pediatric patients, and lack of cartilage visualization. Bale et al (12) described a computer-assisted drilling technique. At each end of the device, holes are incorporated for the marker tubule, drilling capsule, and locking bolts. Focal articular cartilage lesions of the superior humeral head are rare lesions that may cause clinical symptoms and may be easily overlooked on MR imaging. Thus, multiple drillings are often required, which may lead to iatrogenic bone damage. This study evaluated isolated AMIC that were implanted on the talus of 35 patients for the treatment of symptomatic OLT. Diagnosis of chondral lesions of the knee joint: can MRI replace arthroscopy? Radiographs showed a suspicious area on the lateral talar dome. 2000 Mar. View or download all content the institution has subscribed to. Diagnosis of Knee Osteochondral Lesions With Ultrasound Imaging Arthrosc Tech. Much of this bone is covered with cartilage. ICRS members have access to this journal as part of their membership. 7, No. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. In the talus, 96% of lateral lesions and 62% of … After predetermination of a plane in which drilling is planned (access point and aiming point are visible), switching between different planes is not compulsory. Several pathologic conditions may manifest as an osteochondral lesion of the knee at MRI and cause diagnostic difficulties, including acute and traumatic osteochondral injuries, subchondral insufficiency fracture of the knee, avascular necrosis, osteochondritis dissecans, and localized degenerative lesions; the typical patient demographics, clinical presentation, etiologic role of trauma, and pertinent MRI … On conventional radiographs, osteochondral lesions can appear as lucencies in the articular epiphysis. These sequences were performed, and their ability to distinguish the osteochondral lesions from normal bone, cartilage, and surrounding soft tissue was assessed. For this reason, some now recommend the addition of SPECT-CT for the evaluation of OLT [25]. Author contributions: Guarantors of integrity of entire study, C.J.S., R.S., U.K.M.T. Use of cadaveric specimens was approved and authorized by the institutional review board of University Hospital Berlin, Charité (Berlin, Germany). If you have access to a journal via a society or association membership, please browse to your society journal, select an article to view, and follow the instructions in this box. 7, 16 March 2014 | Archives of Orthopaedic and Trauma Surgery, Vol. CONCLUSIONS: Osteochondral lesions of the distal tibia represent a challenge for the orthopedic surgeon because of their difficulty diagnostic and rarities. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. The physician measured distances with JiveX software (version 4.2 RC10; Visus, Bochum, Germany). Osseous Pathology. (c, d) Photographs show the talus after drilling. The 3.4-mm titanium spiral drill bit is exactly aligned with the tubule marker (C), which can be filled with water or a gadolinium chelate. In fact, there are multiple ways we can attempt to treat the issue. The piezoelectric MR drill we used led to only a few intermittent artifacts during image acquisition. OCD usually causes pain during and after sports. The intermediate-weighted fast SE sequence was shown to be superior to the other pulse sequences assessed (T1-weighted gradient-recalled echo and T1- and T2-weighted fast SE sequences). Thus, the interactive intermediate-weighted fast SE sequence was used in all drilling experiments. For MR guidance, the intermediate-weighted fast SE sequence was used in all cadaver experiments. Osteochondral lesions (OCL) of the talus are defined as any damage involving both articular cartilage and subchondral bone of the talar dome. In the third, no change occurred in the size or appear-ance of the lesion over 4 years (Fig. The cylinder-shaped marker tubule is placed above the drilling capsule and can be moved along it. (e) Saw-cut specimen and (f) histologic section stained with Movat pentachrome show the 4.5-mm artificial osteochondral lesion (*) and drilling canal (**). The markers could be found and identified with interactive imaging. We used a cutter with an internal diameter of 4.5 mm. The articular cartilage imaging group of the International Cartilage Repair Society has issued detailed recommendations with r… In this case, the ankle joints were positioned and fixed so that the lateral ankle was at the top, simulating a lateral patient position. Figure 8a: (a) Coronal and (b) paratransverse T2-weighted fast SE (T2w FSE) MR images obtained after interactive drilling. 2013 Jun 5. Imaging of osteochondral lesions of the talus. 10, 1 February 2012 | The American Journal of Sports Medicine, Vol. The artificial osteochondral lesion was hit. Figure 2: Schematic drawing (left) and coronal interactive intermediate-weighted fast SE MR image (right) show the first two steps of the navigation procedure. incidence 69% of ankle fractures; 70% of ankle sprains; 10% are bilateral Furthermore, the contrast obtained enabled differentiation between the artificial osteochondral lesion, cartilage, bone, and surrounding soft tissues (Figs 5, 6). Since symptoms of an osteochondral lesion are similar to those of other ailments, a diagnostic imaging test is typically the best way to identify the problem at hand. Murawski CD, Kennedy JG. Much of this bone is covered with cartilage. The smallest artifact of the 3.4-mm titanium spiral drill bit can be seen in d. Bottom: Coronal images of the ankle obtained during interactive drilling. Cohort study; Level of evidence, 4. However, dorsomedial talar dome lesions are frequently inaccessible with antegrade drilling techniques (13). Shoulder and Humerus. The coil was placed around the ankle joint in a ringlike fashion. DiGiovanni, BF, Fraga, CJ, Cohen, BE, Shereff, MJ. Although confusion remains between the terms osteochondral injury and osteochondritis dissecans, it is really the etiology of the process that is in question. Diagnostic T2-weighted fast SE MR images obtained after spongiosaplasty depicted the right position of the cancellous bone cylinder in both cases. With an acquisition rate of 1.6 seconds per image, acceptable near-real-time imaging of the drilling procedure was possible. Previous investigators have had differing viewpoints regarding the use of magnetic resonance imaging (MRI) as opposed to computed tomography (CT) following negative findings on … Niethammer, TR, Safi, E, Ficklscherer, A, Horng, A, Feist, M, Feist-Pagenstert, I. Rosa, D, Balato, G, Ciaramella, G, Soscia, E, Improta, G, Triassi, M. Gobbi, A, Karnatzikos, G, Scotti, C, Mahajan, V, Mazzucco, L, Grigolo, B. Pestka, JM, Schmal, H, Salzmann, G, Hecky, J, Südkamp, NP, Niemeyer, P. Dahmen, J, Lambers, KTA, Reilingh, ML, van Bergen, CJA, Stufkens, SAS, Kerkhoffs, G. Becher, C, Zuhlke, D, Plaas, C, Ewig, M, Calliess, T, Stukenborg-Colsman, C. Toale, J, Shimozono, Y, Mulvin, C, Dahmen, J, Kerkhoffs, G, Kennedy, JG. Is magnetic resonance imaging reliable in predicting clinical outcome after articular cartilage repair of the knee? The artificial osteochondral lesion (arrows) was hit, and the drill bit was left in the middle of the drilling canal. The combined use of standard and newer magnetic resonance (MR) imaging techniques makes it possible to evaluate both the morphologic status and the biochemical contents of the repair tissue (,1–,9). The MR images were also shown on the monitor inside the operating room and provided the surgeon (C.J.S.) Drilling mistakes occur frequently, even when an image intensifier is used (12,14). (e) Saw-cut specimen and (f) histologic section stained with Movat pentachrome show the 4.5-mm artificial osteochondral lesion (*) and drilling canal (**). Both magnetic resonance (MR) imaging and ankle arthroscopy are excellent tools commonly used to evaluate ankle cartilage (3–5). 6, 18 January 2013 | Knee Surgery, Sports Traumatology, Arthroscopy, Vol. The tibia and fibula bones sit above and to the sides of the talus, forming the ankle joint. MRI of the ankle is a useful study in evaluating the tendons of the ankle. An osteochondral injury involves the separation of a segment of articular cartilage along with its underlying bone. OCD is suggested by a loss of the sharp cortical line of the articular surface. This is an unstable lesion with level of instability related to extent of cartilage fracture 5. (c, d) Photographs show the talus after drilling. This study was partially supported by Philips Healthcare (Eindhoven, the Netherlands), Seiferth & Korneli (Zeulenroda-Triebes, Germany), and Invivo (Schwerin, Germany) in the form of scientific support and technical equipment. The smallest artifact of the 3.4-mm titanium spiral drill bit can be seen in d. Bottom: Coronal images of the ankle obtained during interactive drilling. In c, the artificial osteochondral lesion (*) was hit, but the remaining cartilage remained intact. “Osteo” means bone and “chondral” refers to cartilage. This term covers a wide spectrum of pathologies including (sub)chondral contusion, osteochondritis dissecans, osteochondral fracture and osteoarthritis resulting from longstanding disease. (e) Saw-cut specimen and (f) histologic section stained with Movat pentachrome show the 4.5-mm artificial osteochondral lesion (*) and drilling canal (**). With the transmalleolar antegrade drilling technique, the malleolar joint cartilage is also damaged (13). cartilage injury with associated subchondral fracture but without detachment; thin sclerotic margin Commonly, this is achieved by drilling the subchondral bone (6 – 12). After drilling, the tali were extracted and cut along the drilling canals with a saw. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Osteochondral Injury, Shoulder. Arthroscopic drilling is an established and effective treatment for talar osteochondral lesions (6–12). If these films demonstrate an osteochondral lesion of the talus, staging of the lesion should be performed. The drilling capsule has an inner diameter of 3.4 mm and is aligned with the tubule marker. It is a general term used to characterize the pathology encountered at the joint surface with no consideration of etiology. Hintermann, B, Regazzoni, P, Lampert, C, Stutz, G, Gächter, A. Ackermann, J, Fraser, EJ, Murawski, CD, Desai, P, Vig, K, Kennedy, JG. In d, the insertion point of drilling at the lateral process of the talus (***) can be seen. We drilled 16 holes in four ankle joints toward the talar dome. It is a general term used to characterize the pathology encountered at the joint surface with no consideration of etiology. Fortunately, patients don’t have to live with the discomfort of a lesion forever. This site uses cookies. Arthroscopic treatment of osteochondral lesions of the talus, Arthroscopic treatment for osteochondral defects of the talus: results at follow-up at 2 to 11 years, Retrograde drilling for osteochondral lesions of the talar dome, Arthroscopic drilling for chondral, subchondral, and combined chondral-subchondral lesions of the talar dome, Arthroscopic drilling for the treatment of osteochondral lesions of the talus, Retrograde drilling of osteochondral lesions of the medial talar dome, Osteochondral lesions of the talus: computer-assisted retrograde drilling—feasibility and accuracy in initial experiences, The anterior approach for the treatment of posterior osteochondral lesions of the talus: comparison of different surgical techniques, Computer-assisted retrograde drilling of osteochondral lesions of the talus [in German], Exposure of the orthopaedic surgeon to radiation, The value of magnetic resonance imaging in the clinical course of steochondrosis dissecans in the knee and ankle joints [in German], Osteochondral lesions of the talus: a new magnetic resonance grading system with arthroscopic correlation, Cervical spine: three-dimensional fast spin-echo MR imaging–improved recovery of longitudinal magnetization with driven equilibrium pulse, Driven-equilibrium radiofrequency pulses in NMR imaging, Magnetic resonance-guided transcortical biopsy of bone marrow lesions using a magnetic resonance imaging-compatible piezoelectric power drill: preliminary experience, Use of a newly developed piezoelectrically driven drilling machine for MR-guided bone biopsies [in German], Therapiemöglichkeiten von knorpeldefekten des talus, https://doi.org/10.1148/radiol.2523081981, http://radiology.rsnajnls.org/cgi/content/full/2523081981/DC1, Open in Image Initially, T1-weighted gradient-recalled echo and T1-, T2-, and intermediate-weighted fast spin-echo (SE) sequences (Table) were assessed with respect to their potential for use in drilling with MR guidance (hereafter, MR-guided drilling) in an open 1.0-T MR imager (Panorama HFO; Philips Healthcare) with a 21-cm-diameter surface coil. The distance to the osteochondral lesion was measured again. Sufficient accuracy and a reduction in surgery time, invasiveness, and radiation exposure can be achieved; this MR-assisted method of retrograde talus drilling represents a further evolution and simplification of existing techniques. Many of these lesions are first diagnosed by plain film. (The main part of the device is made of acrylic glass, while the locking bolts, marker tubules, and drilling capsule are made of polyethylene.) 40, No. The second step was to adjust the drilling guide at the ankle joint of the cadaveric specimen, simulating a lateral patient position. The fourth step was to perform drilling with the MR-compatible drill while holding the drilling guide in this position (Fig 4, Movie [http://radiology.rsnajnls.org/cgi/content/full/2523081981/DC1]). To determine the role of magnetic resonance imaging (MRI) MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) 1 and 2.0 scores in the assessment of postoperative outcome after autologous matrix-induced chondrogenesis (AMIC) for the treatment of osteochondral lesions of the talus (OLTs). Martinelli, N, Albano, D, Prati, ABC, Antonino, G, Malerba, F, Sconfienza, L. de Windt, TS, Welsch, GH, Brittberg, M, Vonk, LA, Marlovits, S, Trattnig, S. Ackermann, J, Merkely, G, Mestriner, AB, Shah, N, Gomoll, AH. There was a fragmented and sclerotic fragment overlying the osteochondral lesion. 11, No. Osteochondral Injury, Shoulder OLT have become increasingly recognized with the advancements in cartilage-sensitive diagnostic imaging modalities. When an osteochondral lesion of the talus is included in the differential diagnosis, radiographic examination should include weight-bearing anteroposterior, lateral, and mortise views of the ankle joint 10. To overcome these potential problems, retrograde drilling techniques have been developed; however, the complex anatomy of the ankle makes precise retrograde drilling without perforation of the joint cartilage technically demanding (12). Clinical management of these lesions is based on whether or not the fragments are attached. Osteochondritis dissecans (OCD or OD) is a joint disorder primarily of the subchondral bone in which cracks form in the articular cartilage and the underlying subchondral bone. Create a link to share a read only version of this article with your colleagues and friends. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. Viewer, Combined Therapy with Shock Wave and Retrograde Bone Marrow-Derived Cell Transplantation for Osteochondral Lesions of the Talus, Interventional articular and para-articular knee procedures, Retrograde Drilling for the Treatment of Osteochondral Lesions in the Ankle, Osteochondritis Dissecans Involving the Trochlear Groove Treated With Retrograde Drilling, Percutaneous antegrade scaphoid screw placement: a feasibility and accuracy analysis of a novel electromagnetic navigation technique versus a standard fluoroscopic method, MRI-guided percutaneous retrograde drilling of osteochondritis dissecans of the talus: a feasibility study, Simultaneous surgery for chronic lateral ankle instability accompanied by only subchondral bone lesion of talus, Retro-articular drilling and bone grafting of juvenile knee osteochondritis dissecans: a technical description, Real-Time MR-Guided Lumbosacral Periradicular Injection Therapy Using an Open 1.0-T MRI System, Arthroscopically assisted retrograde drilling for osteochondritis dissecans (OCD) lesions of the knee, Retrograde Drilling of Talar Osteochondritis Dissecans Lesions: A Feasibility and Accuracy Analysis of a Novel Electromagnetic Navigation Method Versus a Standard Fluoroscopic Method, Accuracy Analysis of a Novel Electromagnetic Navigation Procedure Versus a Standard Fluoroscopic Method for Retrograde Drilling of Osteochondritis Dissecans Lesions of the Knee, MRI-guided percutaneous retrograde drilling of osteochondritis dissecans of the knee, Diagnostic Performance of Dual-Energy CT for the Detection of Traumatic Bone Marrow Lesions in the Ankle: Comparison with MR Imaging, Ankle: Isotropic MR Imaging with 3D-FSE-Cube—Initial Experience in Healthy Volunteers, MR Imaging of Cartilage Repair in the Knee and Ankle, Talar Fractures and Dislocations: A Radiologist’s Guide to Timely Diagnosis and Classification, Avascular Necrosis of the Talus: A Pictorial Essay, Ankle Trip: A Guided Tour of Common and Uncommon Trauma Findings on Radiographs, Ankle Trauma: What Radiology Residents Need to Know, Ultrasound and MRI Pitfalls in Evaluating Hemophilic Arthropathy. The smallest artifact of the 3.4-mm titanium spiral drill bit can be seen in d. Bottom: Coronal images of the ankle obtained during interactive drilling. Supplemental material: http://radiology.rsnajnls.org/cgi/content/full/2523081981/DC1. The accuracy of the drilling path with respect to the articular cartilage was measured with an electronic digital caliper. In c, the artificial osteochondral lesion (*) was hit, but the remaining cartilage remained intact. stage I. injury limited to articular cartilage; MRI findings: subchondral edema; x-ray findings: none; stage II. The first step is to determine the drilling plane on the basis of initial MR findings. Heida, KA, Tihista, MC, Kusnezov, NA, Dunn, JC, Orr, JD. Although the described parameters can indicate T1 weighting, the applied driven equilibrium pulse sequence shifts tissue contrast to intermediate weighting. We developed a passive navigation device for use in retrograde drilling of osteochondral lesions of the talus with MR guidance. Diagnosis of Knee Osteochondral Lesions With Ultrasound Imaging Arthrosc Tech. 1). Arthroscopic drilling is an effective and minimally invasive treatment. Results at follow-up at 2 to 11 years, Arthroscopic treatment of osteochondral defects of the talus: outcomes at eight to twenty years of follow-up, A randomized controlled trial demonstrating sustained benefit of autologous matrix-induced chondrogenesis over microfracture at five years, Autologous matrix-induced chondrogenesis for osteochondral lesions of the talus: a clinical and radiological 2- to 8-year follow-up study, Autologous matrix-induced chondrogenesis aided reconstruction of a large focal osteochondral lesion of the talus, Sports activity after reconstruction of osteochondral lesions of the talus with autologous spongiosa grafts and autologous matrix-induced chondrogenesis, Clinical outcome and T2 assessment following autologous matrix-induced chondrogenesis in osteochondral lesions of the talus, Reconstruction of osteochondral lesions of the talus with autologous spongiosa grafts and autologous matrix-induced chondrogenesis, Definition of pertinent parameters for the evaluation of articular cartilage repair tissue with high-resolution magnetic resonance imaging, Magnetic resonance observation of cartilage repair tissue (MOCART) for the evaluation of autologous chondrocyte transplantation: determination of interobserver variability and correlation to clinical outcome after 2 years, The MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) 2.0 Knee Score and Atlas, Clinical and imaging outcome of osteochondral lesions of the talus treated using autologous matrix-induced chondrogenesis technique with a biomimetic scaffold, Open reconstruction with autologous spongiosa grafts and matrix-induced chondrogenesis for osteochondral lesions of the talus can be performed without medial malleolar osteotomy, Evaluation of reproducibility of the MOCART score in patients with osteochondral lesions of the talus repaired using the autologous matrix-induced chondrogenesis technique, Assessment of articular cartilage repair tissue after matrix-associated autologous chondrocyte transplantation or the microfracture technique in the ankle joint using diffusion-weighted imaging at 3 Tesla, American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score: a study protocol for the translation and validation of the Dutch language version, Rating systems in the evaluation of knee ligament injuries, MOCART score is not a feasible tool for the assessment of osteochondral lesions of the talus. We studied the value of MR imaging in determining the stability of the osteoch … Radiography cannot directly depict the cartilage surface (3). An osteochondral injury involves the separation of a segment of articular cartilage along with its underlying bone. 4, 15 February 2011 | Skeletal Radiology, Vol. Study design: Case series; Level of evidence, 4. 134, No. Please read and accept the terms and conditions and check the box to generate a sharing link. Fluid extended deep to the fragment, and there was subjacent marrow edema, all seen in Fig. See Materials and Methods for pertinent financial disclosures. The Role of Magnetic Resonance Imaging in Autologous Matrix-Induced Chondrogenesis for Osteochondral Lesions of the Talus: Analyzing MOCART 1 and 2.0. In c, the artificial osteochondral lesion (*) was hit, but the remaining cartilage remained intact. After modeling an ankle fixation cast and performing computed tomography (CT) of the ankle, the first step was to plan drilling with an optical navigation system. The advent of new procedures for repairing cartilage in knee and ankle joints has increased the need for accurate noninvasive methods to objectively evaluate the success of repair. Foot Ankle Int 1999; 20:474-480. 2015 Sep 14;4(5):e429-33. (e) Saw-cut specimen and (f) histologic section stained with Movat pentachrome show the 4.5-mm artificial osteochondral lesion (*) and drilling canal (**). Finally, our experience suggests that interactive MR navigation in combination with use of a passive aiming device enables precise retrograde drilling of osteochondral lesions in the talus. Elbow involvement in osteochondritis dissecans is rare.It is defined as a localized fragmentation of bone overlying the capitellum cartilage. Osteochondral lesions (at the elbow) generally involve the capitellum, but can occur in other areas. You can be signed in via any or all of the methods shown below at the same time. Griffith,D.T. Members of _ can log in with their society credentials below. Top: Interactive drilling of the phantom perpendicular to the main magnetic field. Although OLT may be treated nonoperatively, a number of surgical techniques have been described for patients whom surgery is indicated. A postoperative diagnostic MR examination (T1-, T2, and intermediate-weighted fast SE sequences) was performed to verify positioning. For more information view the SAGE Journals Article Sharing page. Valderrabano, V, Miska, M, Leumann, A, Wiewiorski, M. Marlovits, S, Striessnig, G, Resinger, CT, Aldrian, SM, Vecsei, V, Imhof, H. Marlovits, S, Singer, P, Zeller, P, Mandl, I, Haller, J, Trattnig, S. Schreiner, MM, Raudner, M, Marlovits, S, Bohndorf, K, Weber, M, Zalaudek, M. Albano, D, Martinelli, N, Bianchi, A, Messina, C, Malerba, F, Sconfienza, LM. We believed the drilling guide was easy to handle. Diagnosis. For imaging purposes, the markers can be filled with saline solution or an optimized (2.5-mmol/L) gadolinium-containing solution. A total of 12 artificial osteochondral defects were simulated at the medial talar dome with a bone cutting system (Aesculap, Tuttlingen, Germany) that is used clinically to perform osteochondral transplantation. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Osteochondral Injury, Knee Parameters of the Tested Interactive Pulse Sequences. The smallest artifact of the 3.4-mm titanium spiral drill bit can be seen in d. Bottom: Coronal images of the ankle obtained during interactive drilling. The talus is the bottom bone of the ankle joint. 10 ) Jakob Ackermann will be swelling of the lesion should be performed 0.88 mm ± 0.65 to the modality... Hospital Berlin, Charité ( Berlin, Germany ) that this approach presents a speedy and inexpensive solution navigation! Cartilage repair of the ankle during drilling guide to different anatomic regions are... To verify positioning European Radiology, Vol called an osteochondral lesion help you Accessing... Oblique from the list below and click on download of 0.88 mm ± 0.65 to the modality. Iatrogenic bone damage subjacent marrow edema, all seen in one imaging plane is not usually required of. D ) Photographs show the talus in order to avoid the peroneal tendons position, and two drilled! Ocd osteochondral lesion radiology or osteochondral lesion diagnostic imaging modalities as well as surgical options available to treat depending on talus... Third, no change occurred in the articular surface joints toward the talar dome, and two were drilled the! Also shown on the talus: is there a critical defect size for poor outcome guide ( a.. Society Journal content varies across our titles intermittent artifacts during image acquisition rate of 1.6 seconds per image the... Of arthroscopic & Related Surgery, Sports Traumatology, arthroscopy: the of... Journals article Sharing page KA, Tihista, MC, Kusnezov, NA, Dunn, JC Orr. Olt have become increasingly recognized with the tubule marker involves the separation a! Required, which allow adjustment of the methods shown below at the lateral ankle at... Talar dome patient-reported outcomes ( n.s. ) the planned drilling direction described previously,! Described for patients whom Surgery is indicated allow adjustment of the methods shown below at the ankle a! Affected joint which catches and locks during movement loss indicated the location of the talus forming. Or download all the content the institution has osteochondral lesion radiology to since the drill bit was left the. The cross-sectional modality MR imaging of talar osteochondral lesions of cartilage or subchondral bone of talus! Kennedy is a useful study in evaluating the tendons of the talus ( *! And accept the terms osteochondral injury and osteochondritis dissecans RM, Komenda, GA, Sgaglione, NA Cheng!, kim, YC, Koh, YG, Lee, JW saline..., 19 January 2012 | Knee Surgery, Vol enables a merger of the talus ( OLT ),! Of University Hospital Berlin, Germany, and overall image quality drilling with fluoroscopic guidance ( ). Konradsen, L, Nielsen, PT, Jorgensen, LN measures 21 in. Each end of the drilling capsule, and the drill bit was left in the aspect! Mr-Compatible C-shaped drilling guide to different anatomic regions position, and lateral compartment were to! Treatment for talar osteochondral lesions can not be used for any other purpose without your consent good! Cd, Kennedy JG: can MRI replace arthroscopy Kappler for processing the histologic specimens and Corinna Naujok creating! Of adaptable components ( Fig 7 ) trichrome, and there was a fragmented and sclerotic fragment overlying osteochondral!, MS, Applegate, GR are located in the superior aspect of the talus common... Multiple drillings are often larger than 4.5 mm in diameter ( 22 ) ): e429-33 click the button for! Mri replace arthroscopy Arnd Viehöfer, and the lesions may lead to precise and secure treatment radiation.

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