[Progress on diagnosis and treatment of cartilage injury of the talus]

Abstract

The diagnosis of osteochondral lesions of the talus can be based on the patients' symptoms, medical history, MRI, detailed physical examination and arthroscopy. Its treatment includes conservative treatment and surgical treatment. Conservative treatment includes rest, partial-weight bearing, plaster immobilization, wear the orthopedic support, take the non-steroidal anti-inflammatory drugs and so on. Conservative treatment is less risky and effective for mild injuries. Surgical treatment includes debridement, marrow stimulation, internal fixation and cartilage transplantation, autologous chondrocyte transplantation, articular cavity injection biological additions, ultrasonic and electromagnetic stimulation technology, tissue engineering technology, etc. Currently, there are various treatment methods, each with indications and advantages and disadvantages. Among these methods, the most commonly used ones are debridement, marrow stimulation, cartilage transplantation and autologous chondrocyte transplantation, and they deserve extensive promotion. Debridement and marrow stimulation are performed minimally traumatically under arthroscopy. The operation is simple and inexpensive with positive effects and mild pain. There is a higher rate of success for small-scale injuries, but if the operation fails, it will result in a wider range of defects, because of the fibrous cartilages formed after the operation. The cartilage transplantation can be performed in an one-stage operation. After the operation, the hyaline cartilage can be restored, but there are different levels of pathological changes in the donor sites. Chondrocytes transplantation can solve the problem of larger osteochondral defects left after the initial treatment failure, and the donor cartilage can be repaired without affecting the donor sites. But the disadvantages are its long time treatment, staged operations and higher cost. As far as all these treatments are concerned, recent treatment effects are satisfactory, but the long-term efficacy is still questionable. For the autologous chondrocyte transplantation and emerging tissue engineering treatment technology, there is still broad research prospect.

Keywords: Cartilage; Review literature; Talus; Wounds and injuries.