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Postoperative Findings, Ankle
Julia R. Crim, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        TERMINOLOGY

        • Definitions

          • Broström procedure
            • Lateral collateral ligament repair augmented with extensor retinaculum transfer
            • Several modifications may be employed
          • Watson-Jones procedure
            • Split peroneus brevis proximal to lateral malleolus
            • Split portion of tendon divided
            • One division threaded through tunnel in lateral malleolus
            • 2nd division left in situ
            • Fibular tunnel will be smooth and round on X-ray and MR
            • Repair should be taut
          • Microfracture
            • Most common treatment of chondral and osteochondral lesions in ankle
            • Drilling of cartilage and subchondral bone
            • Stimulates production of fibrocartilage, which forms new joint surface
            • Bone marrow edema resolves slowly after drilling
            • Over time, drilled area of bone becomes sclerotic
          • Osteochondral autograft transfer system (OATS)
            • Uncommonly used in ankle for osteochondral lesions
            • Plugs of donor cartilage and bone harvested from patient's trochlear groove of knee
            • Cartilage may appear thickened on MR arthrogram
          • Osteochondral allograft
            • En bloc cadaveric allograft may be used to resurface joint
            • Morcellized preparations in matrix may also be used
            • Can use arthrography to evaluate allograft cartilage integrity and bone integration

        IMAGING

        • General Features

          • Imaging Recommendations

            DIFFERENTIAL DIAGNOSIS

              CLINICAL ISSUES

              • Presentation

                Selected References

                1. Looze CA et al: Evaluation and management of osteochondral lesions of the talus. Cartilage. 8(1):19-30, 2017
                2. Orr JD et al: Results and functional outcomes of structural fresh osteochondral allograft transfer for treatment of osteochondral lesions of the talus in a highly active population. Foot Ankle Spec. 10(2):125-132, 2017
                3. Rodriguez EG et al: Treatment of osteochondral lesions of the talus with cryopreserved talar allograft and ankle distraction with external fixation. Surg Technol Int. 15:282-8, 2006
                4. Lee CH et al: Osteochondral autografts for osteochondritis dissecans of the talus. Foot Ankle Int. 24(11):815-22, 2003
                5. Messer TM et al: Outcome of the modified Broström procedure for chronic lateral ankle instability using suture anchors. Foot Ankle Int. 21(12):996-1003, 2000
                Related Anatomy
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                Related Differential Diagnoses
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                References
                Tables

                Tables

                KEY FACTS

                • Terminology

                  • Imaging

                    • Top Differential Diagnoses

                      TERMINOLOGY

                      • Definitions

                        • Broström procedure
                          • Lateral collateral ligament repair augmented with extensor retinaculum transfer
                          • Several modifications may be employed
                        • Watson-Jones procedure
                          • Split peroneus brevis proximal to lateral malleolus
                          • Split portion of tendon divided
                          • One division threaded through tunnel in lateral malleolus
                          • 2nd division left in situ
                          • Fibular tunnel will be smooth and round on X-ray and MR
                          • Repair should be taut
                        • Microfracture
                          • Most common treatment of chondral and osteochondral lesions in ankle
                          • Drilling of cartilage and subchondral bone
                          • Stimulates production of fibrocartilage, which forms new joint surface
                          • Bone marrow edema resolves slowly after drilling
                          • Over time, drilled area of bone becomes sclerotic
                        • Osteochondral autograft transfer system (OATS)
                          • Uncommonly used in ankle for osteochondral lesions
                          • Plugs of donor cartilage and bone harvested from patient's trochlear groove of knee
                          • Cartilage may appear thickened on MR arthrogram
                        • Osteochondral allograft
                          • En bloc cadaveric allograft may be used to resurface joint
                          • Morcellized preparations in matrix may also be used
                          • Can use arthrography to evaluate allograft cartilage integrity and bone integration

                      IMAGING

                      • General Features

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            CLINICAL ISSUES

                            • Presentation

                              Selected References

                              1. Looze CA et al: Evaluation and management of osteochondral lesions of the talus. Cartilage. 8(1):19-30, 2017
                              2. Orr JD et al: Results and functional outcomes of structural fresh osteochondral allograft transfer for treatment of osteochondral lesions of the talus in a highly active population. Foot Ankle Spec. 10(2):125-132, 2017
                              3. Rodriguez EG et al: Treatment of osteochondral lesions of the talus with cryopreserved talar allograft and ankle distraction with external fixation. Surg Technol Int. 15:282-8, 2006
                              4. Lee CH et al: Osteochondral autografts for osteochondritis dissecans of the talus. Foot Ankle Int. 24(11):815-22, 2003
                              5. Messer TM et al: Outcome of the modified Broström procedure for chronic lateral ankle instability using suture anchors. Foot Ankle Int. 21(12):996-1003, 2000