gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie, 75. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 97. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 52. Tagung des Berufsverbandes der Fachärzte für Orthopädie und Unfallchirurgie

25. - 28.10.2011, Berlin

Computertomographic evaluation of talar edge configuration for osteochondral plug transplantation

Meeting Abstract

  • M. Wiewiorski - Universitätsspital Basel, Orthopädische Klinik, Basel, Switzerland
  • S. Hoechel - Universitätsspital Basel, Orthopädische Klinik, Basel, Switzerland
  • K. Wishart - Universitätsspital Basel, Orthopädische Klinik, Basel, Switzerland
  • M. Müller-Gerbl - Anatomisches Institut Universität Basel, Basel, Switzerland
  • V. Valderrabano - Universitätsspital Basel, Orthopädische Klinik, Bewegungszentrum Untere Extremität, Basel, Switzerland
  • A.M. Nowakowski - Universitätsspital Basel, Orthopädische Klinik, Basel, Switzerland

Deutscher Kongress für Orthopädie und Unfallchirurgie. 75. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 97. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 52. Tagung des Berufsverbandes der Fachärzte für Orthopädie. Berlin, 25.-28.10.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocPO13-325

DOI: 10.3205/11dkou567, URN: urn:nbn:de:0183-11dkou5674

Veröffentlicht: 18. Oktober 2011

© 2011 Wiewiorski et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Questionnaire: One of the current research topics is the aim to produce tissue engineered osteochondral grafts for future treatment of osteochondral lesions (OCL) of the talus. For the exact anatomic reconstruction, the dimensions of the medial and lateral talar dome must be considered. Sparse data is available regarding the normal anatomic talar dimensions on standard radiographs of ankle joints [1], [2]. The purpose of this study was to describe normal anatomy of different sections of the talar dome on 3D

reconstructions of computertomographic (CT) images.

Methods: CT data sets (Somatom 10, Siemens Erlangen, Germany) of 82 patients (86 ankles) (28 female, 54 male; average age 41.9y (range 15-76y)) without talar pathologies were included.

Measurements were performed with a geometry analysis software (VGStudio MAX 2.0, Volume Graphics, Heidelberg, Germany). To assure measurement reproducibility, the reference planes were defined in a first step. To measure the frontal talar edge radius , circles were fitted into the medial and lateral talar edge on frontal planes. To allow measurement of different segments of the talus, the frontal plane was tilted through the center of the talus (defined as a circle fitted to the talus on sagittal view) at 15° and 30° anteriorly and posteriorly. To measure the sagittal radius of the medial and talar edge, ircles were fitted into the medial and lateral talar edge on sagittal planes.

Results and Conclusions: The talar edge radius in the frontal plane at 0° wa s 4.9 mm medially (3.0 mm laterally), at 15° ant. 4.2 mm (3.1 mm), at 30° ant. 4.6 mm (3.1 mm), at 15° post. 4.5 mm (3.9 mm), and at 30° post 4.1 mm (6 mm). There was a significant difference (p< 0.01) between the mean medial and lateral talar edge radius at all angles. The talar edge radius in the sagittal plane was 20.4 mm medially and 20.3 laterally. There was no significant difference between the mean medial and lateral sagittal.

This study shows a significant difference between physiological medial and lateral edge configuration at different frontal planes of the talar dome. No difference was found comparing the sagittal radius of the medial and talar dome. The assessed data provides important aid for engineering of pre-formed, pre-sized osteochondral grafts. Such pre-shaped grafts could help restoring the physiological joint surface by matching exactly into the lesion and consequently achieving the recovery of the physiological joint biomechanics and prevention of secondary degenerative disease.


References

1.
Leumann A, et al. Radiographic evaluation of frontal talar edge configuration for osteochondral plug transplantation. Clin Anat. 2009;22(2):261-6.
2.
Riede UN, Heitz P, Ruedi T. [Studies of the joint mechanics elucidating the pathogenesis of posttraumatic arthrosis of the ankle joint in man. II. Influence of the talar shape on the biomechanics of the ankle joint]. Langenbecks Arch Chir. 1971;330(2):174-84.