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01-07-2014 | Interventional

MRI-guided percutaneous retrograde drilling of osteochondritis dissecans of the talus: a feasibility study

Authors: Pekka Kerimaa, Risto Ojala, Juha-Jaakko Sinikumpu, Pekka Hyvönen, Jussi Korhonen, Paula Markkanen, Osmo Tervonen, Roberto Blanco Sequeiros

Published in: European Radiology | Issue 7/2014

Abstract

Objectives

The purpose of this study was to evaluate the feasibility of MRI guidance for percutaneous retrograde drilling in the treatment of osteochondritis dissecans of the talus (OCDT).

Methods

Four patients, one juvenile and three adults, with one OCDT lesion each and persisting ankle pain after conservative treatment, were treated with MRI-guided retrograde drilling. All lesions were stable and located in the middle or posterior medial third of the talar dome. Pain relief and the ability to return to normal activities were assessed during clinical follow-up. MRI and plain film radiographs were used for imaging follow-up.

Results

Technical success was 100 % with no complications and with no damage to the overlying cartilage. All patients experienced some clinical benefit, although only one had complete resolution of pain and one had a relapse leading to surgical treatment. Changes in the pathological imaging findings were mostly very slight during the follow-up period.

Conclusions

MRI guidance seems accurate, safe and technically feasible for retrograde drilling of OCDT. Larger series are needed to reliably assess its clinical value.

Key Points

• MRI serves as a useful guidance method for numerous mini-invasive applications.

• Retrograde drilling is a cartilage-sparing alternative in the treatment of osteochondritis dissecans.

• MRI guidance seems feasible for treatment of osteochondritis dissecans of the talus.

Murawski CD, Kennedy JG (2013) Operative treatment of osteochondral lesions of the talus. J Bone Joint Surg Am 95:1045–1054

Navid DO, Myerson MS (2002) Approach alternatives for treatment of osteochondral lesions of the talus. Foot Ankle Clin 7:635–649PubMedCrossRef

Lam KY, Siow HM (2012) Conservative treatment for juvenile osteochondritis dissecans of the talus. J Orthop Surg 20:176–180

Perumal V, Wall E, Babekir N (2007) Juvenile osteochondritis dissecans of the talus. J Pediatr Orthop 27:821–825PubMedCrossRef

Zwingmann J, Sudkamp NP, Schmal H, Niemeyer P (2012) Surgical treatment of osteochondritis dissecans of the talus: A systematic review. Arch Orthop Trauma Surg 132:1241–1250

van Bergen CJ, de Leeuw PA, van Dijk CN (2008) Treatment of osteochondral defects of the talus. Rev Chir Orthop Reparatrice Appar Mot 94:398–408

Elias I, Zoga AC, Morrison WB, Besser MP, Schweitzer ME, Raikin SM (2007) Osteochondral lesions of the talus: localization and morphologic data from 424 patients using a novel anatomical grid scheme. Foot Ankle Int 28:154–161PubMedCrossRef

Hembree WC, Wittstein JR, Vinson EN et al (2012) Magnetic resonance imaging features of osteochondral lesions of the talus. Foot Ankle Int 33:591–597

Taranow WS, Bisignani GA, Towers JD, Conti SF (1999) Retrograde drilling of osteochondral lesions of the medial talar dome. Foot Ankle Int 20:474–480PubMedCrossRef

10.

Kono M, Takao M, Naito K, Uchio Y, Ochi M (2006) Retrograde drilling for osteochondral lesions of the talar dome. Am J Sports Med 34:1450–1456PubMedCrossRef

11.

Heywood CS, Benke MT, Brindle K, Fine KM (2011) Correlation of magnetic resonance imaging to arthroscopic findings of stability in juvenile osteochondritis dissecans. Arthroscopy 27:194–199

12.

Hoffmann M, Petersen JP, Schroder M et al (2012) Retrograde drilling of talar osteochondritis dissecans lesions: a feasibility and accuracy analysis of a novel electromagnetic navigation method versus a standard fluoroscopic method. Arthroscopy 28:1547–1554

13.

Rosenberger RE, Fink C, Bale RJ, El Attal R, Muhlbacher R, Hoser C (2006) Computer-assisted minimally invasive treatment of osteochondrosis dissecans of the talus. Oper Orthop Traumatol 18:300–316PubMedCrossRef

14.

Bale RJ, Hoser C, Rosenberger R, Rieger M, Benedetto KP, Fink C (2001) Osteochondral lesions of the talus: Computer-assisted retrograde drilling—feasibility and accuracy in initial experiences. Radiology 218:278–282PubMedCrossRef

15.

Geerling J, Zech S, Kendoff D et al (2009) Initial outcomes of 3-dimensional imaging-based computer-assisted retrograde drilling of talar osteochondral lesions. Am J Sports Med 37:1351–1357

16.

Gras F, Marintschev I, Muller M et al (2010) Arthroscopic-controlled navigation for retrograde drilling of osteochondral lesions of the talus. Foot Ankle Int 31:897–904

17.

Seebauer CJ, Bail HJ, Rump JC, Walter T, Teichgraber UK (2010) Advancements in orthopedic intervention: retrograde drilling and bone grafting of osteochondral lesions of the knee using magnetic resonance imaging guidance. Cardiovasc Intervent Radiol 33:1230–1234

18.

Ojala R, Kerimaa P, Lakovaara M et al (2011) MRI-guided percutaneous retrograde drilling of osteochondritis dissecans of the knee. Skeletal Radiol 40:765–770PubMedCrossRef

19.

Blanco Sequeiros R, Vahasarja V, Ojala R (2008) Magnetic resonance-guided growth plate bone bridge resection at 0.23 tesla: report of a novel technique. Acta Radiol 49:668–672

20.

Kerimaa P, Marttila A, Hyvönen P et al (2013) MRI-guided biopsy and fine needle aspiration biopsy (FNAB) in the diagnosis of musculoskeletal lesions. Eur J Radiol 82:2328–2333PubMedCrossRef

21.

Blanco Sequeiros R, Klemola R, Ojala R, Jyrkinen L, Vaara T, Tervonen O (2003) Percutaneous MR-guided discography in a low-field system using optical instrument tracking: A feasibility study. J Magn Reson Imaging 17:214–219CrossRef

22.

Seebauer CJ, Bail HJ, Wichlas F et al (2009) Osteochondral lesions of the talus: Retrograde drilling with high-field-strength MR guidance. Radiology 252:857–864

23.

Berndt AL, Harty M (2004) Transchondral fractures (osteochondritis dissecans) of the talus. J Bone Joint Surg Am 86-A:1336PubMed

Title: MRI-guided percutaneous retrograde drilling of osteochondritis dissecans of the talus: a feasibility study
Authors: Pekka Kerimaa
Risto Ojala
Juha-Jaakko Sinikumpu
Pekka Hyvönen
Jussi Korhonen
Paula Markkanen
Osmo Tervonen
Roberto Blanco Sequeiros
Publication date: 01-07-2014
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 7/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3161-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

MRI-guided percutaneous retrograde drilling of osteochondritis dissecans of the talus: a feasibility study

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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