Arthroscopic treatment for an osteochondral defect of the talus after necrosis associated with acute lymphoblastic leukaemia: a case report.
Osteonecrosis is a serious complication of acute lymphoblastic leukemia (ALL) therapy. The spontaneous regression or healing of osteonecrosis is rare. An unusual case of an osteochondral defect of the talus secondary to osteonecrosis is herein presented. We treated a 26-year-old female who presented with an osteochondral defect of the talus after necrosis. ALL had previously been diagnosed in 1994 and the patients had been treated with chemotherapy included corticosteroid. She was thereafter diagnosed to have bilateral osteonecrosis of the talus in 1996, and thus had been treated with weight-bearing restriction using a patellar tendon bearing brace. She felt pain in her right ankle in 2006. Magnetic resonance imaging (MRI) showed an osteochondral defect in the lateral aspect of the talus and normal bone marrow signal in the right ankle. We performed arthroscopic treatment by means of a bone marrow stimulation technique. At second-look arthroscopy, the aspect of the talus was completely covered by fibrocartilage like tissue. This procedure is therefore considered to be one option for the treatment of an osteochondral defect of the talus after necrosis in young patients.
Department of Orthopaedic Surgery, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan. ichiroy@cis.fukuoka-u.ac.jp
Ichiro
I
Yoshimura
Masatoshi
M
Naito
Kazuki
K
Kanazawa
Akinori
A
Takeyama
Hirotaka
H
Karashima
Takahiro
T
Ida
Tomohiro
T
Nomura
D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D001182:Arthroscopy; D001853:Bone Marrow / Q000502:physiology; D002356:Cartilage / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D010020:Osteonecrosis / Q000139:chemically induced* / Q000601:surgery*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy; D013628:Talus / Q000473:pathology / Q000601:surgery*; D014945:Wound Healing
D000305:Adrenal Cortex Hormones