Medial talar dome11/10/2023 Acute non-displaced OLTs can be treated non-surgically with successful results in up to 50% of cases. 3 Patients with symptomatic OLTs will normally suffer from prolonged pain, swelling, locking and catching of the ankle joint. 2 They can be diagnosed by plain radiography, computerized tomography (CT), magnetic resonance imaging (MRI) and arthroscopy OLT classifications among these diagnostic techniques also vary. 1 OLTs are mainly associated with trauma, with the majority of defects occurring in young people aged between 20 and 40 years, following ankle sprains or fractures. In general, OLTs refer to any defect of the ankle articular cartilage and underlying subchondral bone. Osteochondral lesions of the talus (OLTs), also known as talar osteochondral defects, include many varieties of pathologies such as osteochondritis dissecans, transchondral fractures and osteochondral fractures. In this review, we summarise the clinical management of OLTs and present the current concepts of different treatment regimes. Biological attempts at either regenerating or replacing the articular cartilage are however demonstrating some promising results, but each with their own advantages and disadvantages. Although bone marrow stimulation techniques remain the “gold standard” for lesions <150 mm 2, there still requires a need for better long term clinical data and cost-benefit analyses compared with other treatment options. In these cases, conservative treatments are often unsuccessful, particularly for larger and more severe defects and so the majority require surgical intervention. However, OLTs refractory to non-surgical care for three to six months may be suitable for surgical care. Acute non-displaced OLTs can be treated non-operatively. Left untreated, OLTs risk progressing to osteoarthritis. Diagnosis of OLTs requires a combination of clinical assessment and imaging and despite many different treatment options, there is no generalised consensus regarding which option is the most effective. Osteochondral lesions of the talus (OLTs) are a common complication following trauma, involving both the articular cartilage and the underlying subchondral bone, with variable aetiologies and often presenting with non-specific symptoms.
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