Osteochondral Grafting of the Distal Tibia Without a Malleolar Osteotomy: An All-Arthroscopic Antegrade Approach
Author
Perera, Anthony
Beddard, Laura
Curran, Sarah
Robertson, Angus
Date
2015-09Type
Article
Publisher
Wolters Kluwer Health
ISSN
1536-0644
Metadata
Show full item recordAbstract
Osteochondral (OCD) lesions of the tibia are rare and can be treated with microfracture and debridement in the first instance. However, a major issue arises if bulk-grafting is required as access to the joint surface for perpendicular packing/insertion is not possible. Tibial osteotomy for access to the talus has morbidity associated with it, but moreover it does not significantly improve access to the tibia for standard retrograde (ie, from the joint surface into the bone) drilling and insertion of a graft into an OCD lesion. In order to obviate the need for malleolar osteotomy an antegrade approach through the bone rather than the joint can be used avoiding any disruption of the joint. We have developed this technique for use in the tibia and the talus and present a case of OCD autografting of the tibia to demonstrate this method of insertion without osteotomy. A jig is used to locate the surface of the lesion and then the tunnel is prepared by drilling onto this marker from the opposite side of the bone. This produces an oblique tunnel that requires harvesting of a matched graft. Insertion can then be performed from outside-in.
Level of Evidence: Diagnostic Level 5. See Instructions for Authors for a complete description of levels of evidence.
Journal/conference proceeding
Techniques in Foot and Ankle Surgery
Citation
Perera, A., Beddard, L., Curran, S. and Robertson, A. (2015) 'Osteochondral grafting of the distal tibia without a malleolar osteotomy: an all-arthroscopic antegrade approach', Techniques in Foot & Ankle Surgery, 14(3), pp.120-127.
Description
This article was published in Techniques in Foot and Ankle Surgery in September 2015 available at http://dx.doi.org/10.1097/BTF.0000000000000097 The author's post-print is made available in this repository from 01 October 2016
Collections
Related items
Showing items related by title, author, subject and abstract.
-
Amelioration of non-motor dysfunctions after transplantation of human dopamine neurons in a model of Parkinson's disease
Lelos, M.J.; Morgan, R.J.; Kelly, Claire; Torres, E.M.; Rosser, A.E.; Dunnett, S.B. (Science Direct, 2016-02-04)Patients suffering from Parkinson's disease (PD) display cognitive and neuropsychiatric dysfunctions, especially with disease progression. Although these impairments have been reported to impact more heavily upon a patient's ... -
Dopamine-rich grafts alleviate deficits in contralateral response space induced by extensive dopamine depletion in rats
Heuer, Andreas; Lelos, Mariah; Kelly, Claire; Torres, Eduardo; Dunnett, Stephen (Elsevier, 2013)Unilateral infusion of 6-hydroxydopamine into the nigro-striatal pathway in the rat is the most common dopamine lesion model of Parkinson's disease. In the present study, we explore the impact of near complete unilateral ... -
Quadriceps muscle compensatory activations are delayed following anterior cruciate ligament reconstruction using hamstring tendon graft
Labanca, Luciana; Laudani, Luca; Mariani, Pier Paolo; Macaluso, Andrea (Elsevier, 2020-01-03)Objective: To investigate compensatory and anticipatory quadriceps muscle activations before and after anterior cruciate ligament reconstruction (ACLR) using hamstrings tendon graft. Design:Twelve participants ...