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Latest Surgical Technique

May 22, 2013

Arthroscopic Treatment of Osteochondral Talar Defects

by Christiaan J.A. van Bergen, MD; Ruben Zwiers, MSc; C. Niek van Dijk, MD, PhD

Overview

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

Indications

Contraindications

Pitfalls & Challenges

More Surgical Techniques

March 27, 2013

Dual Growing Rods for the Treatment of Early-Onset Scoliosis

by Gregory M. Mundis, MD; Nima Kabirian, MD; Behrooz A. Akbarnia, MD

March 13, 2013

Distal Rectus Femoris Tendon Transfer for the Correction of Stiff-Knee Gait in Cerebral Palsy

by T. Dreher, MD; F. Braatz, MD; S.I. Wolf, PhD; V. Ewerbeck, MD; D. Heitzmann, MSc; W. Wenz, MD; L. Döderlein, MD

February 27, 2013

Surgical Treatment of Overcorrected Clubfoot Deformity

by Markus Knupp, MD; Alexej Barg, MD; Lilianna Bolliger, MSc; Ashley L. Kapron, BS; Beat Hintermann, MD

February 13, 2013

Anatomic, Transepiphyseal Anterior Cruciate Ligament Reconstruction

by Kyle E. Hammond, MD; John W. Xerogeanes, MD; Dane C. Todd, MD

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Recently Published in The Journal of Bone & Joint Surgery:

Adverse Local Tissue Reaction Arising from Corrosion at the Femoral Neck-Body Junction in a Dual-Taper Stem with a Cobalt-Chromium Modular Neck

The Effect of Recombinant Human Bone Morphogenetic Protein-2 in Single-Level Posterior Lumbar Interbody Arthrodesis

Recently Published in JBJS Case Connector:

Intra-Articular Metastasis of Lung Carcinoma Presenting as Pigmented Villonodular Synovitis of the Knee: A Case Report

Leg Constriction by Electronic Security Bracelets That Are Obscured by a Pavlik Harness: A Report of Two Cases

Go to Journal of Bone & Joint Surgery

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Go to jbjsjobs.org

03/20/2013 BOARD CERTIFIED SPINE & SPORTS MEDICINE NJ - Wayne J. Altman, MD, PA	05/01/2013 Orthopedic Total Joint Lead Position Central Connecticut CT - Cejka Search for Bristol Hospital
04/17/2013 PROFESSOR AND VICE-CHAIR FOR RESEARCH TX - UT Health	06/29/2012 One Year Fellowships PA - Thomas Jefferson University

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Current Discussion

John H. Wedge, MD, FRCS(C) responds to:

Outcome at Forty-five Years After Open Reduction and Innominate Osteotomy for Late-Presenting Developmental Dislocation of the HipSurgical Technique

I would like to thank Mr. Cove for pointing out an obvious typographical error in our manuscript. The vessel described is indeed a branch of the lateral, rather than the medial circumflex femoral a

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