Christiaan J A van Bergen1, Ruben Zwiers1, C Niek van Dijk1. 1. Department of Orthopaedic Surgery, Orthopaedic Research Center Amsterdam, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. E-mail address for C.J.A. van Bergen: c.j.vanbergen@amc.nl. E-mail address for R. Zwiers: r.zwiers@amc.nl. E-mail address for C.N. van Dijk: c.n.vandijk@amc.nl.
Abstract
INTRODUCTION: Arthroscopic debridement and bone marrow stimulation (i.e., drilling or microfracturing) is considered the primary surgical treatment of osteochondral defects of the talus. STEP 1 POSITION THE PATIENT: For anterior ankle arthroscopy, position the patient supine; for posterior arthroscopy, position the patient prone. STEP 2 ARTHROSCOPIC APPROACH: For anterior ankle arthroscopy, place the portals medial to the tibialis anterior tendon and lateral to the peroneus tertius tendon at the level of the ankle joint; for posterior arthroscopy, place the portals lateral and medial to the Achilles tendon just above the level of the tip of the lateral malleolus. STEP 3 DEBRIDEMENT AND BONE MARROW STIMULATION: Fully debride the osteochondral defect and create multiple microfractures in the bottom of the defect. STEP 4 CLOSURE AND POSTOPERATIVE CARE: Prescribe partial weight-bearing for six weeks. RESULTS: A systematic review of the literature identified eighteen studies on bone marrow stimulation that included a total of 388 patients3. The study weighted success rate was 85% (range, 46% to 100%). WHAT TO WATCH FOR: IndicationsContraindicationsPitfalls & Challenges.
INTRODUCTION: Arthroscopic debridement and bone marrow stimulation (i.e., drilling or microfracturing) is considered the primary surgical treatment of osteochondral defects of the talus. STEP 1 POSITION THE PATIENT: For anterior ankle arthroscopy, position the patient supine; for posterior arthroscopy, position the patient prone. STEP 2 ARTHROSCOPIC APPROACH: For anterior ankle arthroscopy, place the portals medial to the tibialis anterior tendon and lateral to the peroneus tertius tendon at the level of the ankle joint; for posterior arthroscopy, place the portals lateral and medial to the Achilles tendon just above the level of the tip of the lateral malleolus. STEP 3 DEBRIDEMENT AND BONE MARROW STIMULATION: Fully debride the osteochondral defect and create multiple microfractures in the bottom of the defect. STEP 4 CLOSURE AND POSTOPERATIVE CARE: Prescribe partial weight-bearing for six weeks. RESULTS: A systematic review of the literature identified eighteen studies on bone marrow stimulation that included a total of 388 patients3. The study weighted success rate was 85% (range, 46% to 100%). WHAT TO WATCH FOR: IndicationsContraindicationsPitfalls & Challenges.
Authors: Christiaan J A van Bergen; Gabriëlle J M Tuijthof; Leendert Blankevoort; Mario Maas; Gino M M J Kerkhoffs; C Niek van Dijk Journal: Arthroscopy Date: 2012-02-17 Impact factor: 4.772
Authors: Christiaan J A van Bergen; Peter A J de Leeuw; C Niek van Dijk Journal: Knee Surg Sports Traumatol Arthrosc Date: 2008-09-23 Impact factor: 4.342
Authors: Peter A J de Leeuw; Pau Golanó; Inger N Sierevelt; C Niek van Dijk Journal: Knee Surg Sports Traumatol Arthrosc Date: 2010-03-12 Impact factor: 4.342
Authors: C Niek van Dijk; Mikel L Reilingh; Maartje Zengerink; Christiaan J A van Bergen Journal: Knee Surg Sports Traumatol Arthrosc Date: 2010-02-12 Impact factor: 4.342
Authors: Maartje Zengerink; Peter A A Struijs; Johannes L Tol; Cornelis Niek van Dijk Journal: Knee Surg Sports Traumatol Arthrosc Date: 2009-10-27 Impact factor: 4.342