A comparison of surgical exposures for posterolateral osteochondral lesions of the talar dome

TY - JOUR

T1 - A comparison of surgical exposures for posterolateral osteochondral lesions of the talar dome

AU - Mayne, Alistair I. W.

AU - Lawton, Robert

AU - Reidy, Michael J.

AU - Harrold, Fraser

AU - Chami, George

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Background: Perpendicular access to the posterolateral talar dome for the management of osteochondral defects is difficult. We examined exposure available from each of four surgical approaches.Materials and methods: Four surgical approaches were performed on 9 Thiel-embalmed cadavers: anterolateral approach with arthrotomy; anterolateral approach with anterior talo-fibular ligament (ATFL) release; anterolateral approach with antero-lateral tibial osteotomy; and anterolateral approach with lateral malleolus osteotomy. The furthest distance posteriorly allowing perpendicular access with a 2 mm k-wire was measured.Results: An anterolateral approach with arthrotomy provided a mean exposure of the anterior third of the lateral talar dome. A lateral malleolus osteotomy provided superior exposure (81.5% vs 58.8%) compared to an anterolateral tibial osteotomy.Conclusions: Only the anterior half of the lateral border of the talar dome could be accessed with an anterolateral approach without osteotomy. A fibular osteotomy provided best exposure to the posterolateral aspect of the talar dome.

AB - Background: Perpendicular access to the posterolateral talar dome for the management of osteochondral defects is difficult. We examined exposure available from each of four surgical approaches.Materials and methods: Four surgical approaches were performed on 9 Thiel-embalmed cadavers: anterolateral approach with arthrotomy; anterolateral approach with anterior talo-fibular ligament (ATFL) release; anterolateral approach with antero-lateral tibial osteotomy; and anterolateral approach with lateral malleolus osteotomy. The furthest distance posteriorly allowing perpendicular access with a 2 mm k-wire was measured.Results: An anterolateral approach with arthrotomy provided a mean exposure of the anterior third of the lateral talar dome. A lateral malleolus osteotomy provided superior exposure (81.5% vs 58.8%) compared to an anterolateral tibial osteotomy.Conclusions: Only the anterior half of the lateral border of the talar dome could be accessed with an anterolateral approach without osteotomy. A fibular osteotomy provided best exposure to the posterolateral aspect of the talar dome.

KW - Osteochondral defect

KW - Osteochondral lesion

KW - Surgical approach

KW - Talus

U2 - 10.1016/j.fas.2016.11.012

DO - 10.1016/j.fas.2016.11.012

M3 - Article

C2 - 29409232

AN - SCOPUS:85010781162

SN - 1268-7731

VL - 24

SP - 107

EP - 109

JO - Foot and Ankle Surgery

JF - Foot and Ankle Surgery

IS - 2

ER -