Talasun osteokondral lezyonunda retrograd osteokondral greftleme: Malleol osteotomisi gerektirmeyen yeni bir teknik

Osteokondral greftleme talustaki osteokondral lezyonlar ın tedavisinde en etkili yöntemlerden biridir. Girişim sı- rasında malleol osteotomisinin gerekmesi tekniğin en önemli sorunudur. Bu yazıda, medial malleol osteotomisi yapmadan, ters yolla otojen osteokondral greftleme ile tedavi edilen bir olgu sunuldu. Kırk dokuz yaşında bir kad ın hastanın talus medialinde 9 mm çaplı osteokondral lezyon saptandı. Talusa sinös tarsi bölgesinden girilip lezyon bölgesine uzanan bir tünel, artroskopi kontrolünde açıldı. Üpsilateral dizden alınan osteokondral greftin yönü değiştirilerek tünele distal ucundan sokuldu ve eklem yü- zeyine kadar ilerletildi. Ameliyattan sonra yapıılan bilgisayarl ı tomografi incelemesinde, greftin tüneli tam olarak doldurduğu ve greft yüksekliğinin uygun olduğu görüldü. Bu yazıda, kullanılan teknik ayrıntılı olarak anlatıldı.

Anahtar Kelimeler:

Artroskopi, Kemik nakli, Kıkırdak, Talus, Nakil, otolog

Retrograde osteochondral grafting for osteochondral lesion of the talus: A new technique eliminating malleolar osteotomy

Osteochondral grafting is one of the most effective treatment options for osteochondral lesions of the talus. However, the necessity for a medial malleolar osteotomy is the major drawback of the technique. This report presents a case treated with retrograde osteochondral grafting that eliminated the need for a medial malleolar osteotomy. An osteochondral lesion of the medial talus was detected in a 49-year-old woman. Under arthroscopic guidance, the talus was entered from the sinus tarsi region to establish a tunnel extending to the lesion. An osteochondral graft taken from the ipsilateral knee was inserted into the distal end of the tunnel and was advanced to the joint surface. Postoperative computed tomography scans showed that the graft completely filled the tunnel and provided congruency with the articular surface. Details of this technique are described.

Keywords:

Arthroscopy, Bone Transplantation, Cartilage, Talus, Transplantation, Autologous,

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