Osteohondritis disekans talusa

master's thesis

• Title (english): Osteochondritis dissecans of the talus
• Author: Andrija Jurina
• Mentor: Ivan Bojanić (mentor)
• Committee member: Tomislav Smoljanović (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Ivan Bojanić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Orthopedics); Zagreb
• Defense date and country: 2014-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Orthopedics

Abstract

Osteohondritis disekans (OCD) talusa označava odvajanje komadića zglobne hrskavice
kupole talusa s dijelom ili bez dijela pripadajuće suphondralne kosti. Trauma se smatra
najvjerojatnijim uzrokom, a najčešći simptom je dugotrajna bol u gležnju nejasne lokalizacije. Za
postavljanje dijagnoze, detaljan klinički pregled nužno je kombinirati sa standardnim radiološkim
snimanjem, kompjutoriziranom tomografijom ili magnetskom rezonancom. Pojedini autori za
OCD talusa predlažu samo neoperacijsko liječenje (imobilizacijom, nesteroidnim protuupalnim
lijekovima i modifikacijom tjelesne aktivnosti), ali većina se zalaže za kirurški način liječenja.
Artroskopska stimulacija koštane srži tehnikom mikrofraktura je primarna metoda u liječenju
simptomatskih OCD-a talusa. Ova metoda je jeftina, tehnički nezahtjevna, s malim brojem
komplikacija. Unatoč velikom broju dobrih i odličnih rezultata objavljenih u literaturi nakon
liječenja ovom metodom, primjećeno je progresivno pogoršanje rezultata tijekom duljeg vremena
praćenja. Naše istraživanje obuhvatilo je 127 slučajeva OCD talusa (123 bolesnika) operiranih
metodom mikrofraktura u Klinici za ortopediju Kliničkoga bolničkog centra Zagreb. Prosječno
vrijeme praćenja bolesnika u poslijeoperacijskom razdoblju bilo je 76,5 mjeseci (raspon mjeseci
15 do 177). Veliki broj slučajeva OCD-a te dugo poslijeoperacijsko vrijeme praćenja čini ovo
istraživanje dobrim temeljem za provođenje daljnjeg istraživanja kojim bi se utvrdila dugoročna
učinkovitost metode mikrofraktura u liječenju simptomatskog OCD-a talusa.

Abstract (english)

Osteochondritis dissecans (OCD) of the talus is a detachment of articular cartilage from
the talar dome, with or without a part of underlying subchondral bone. Trauma is the predominant
aetiology of OCD of the talus and the most common symptom is persistent deep ankle pain.
Thorough clinical examination in combination with standardized radiological procedures,
computed tomography and magnetic resonance is essential for establishing the final diagnosis.
Several authors for OCD of the talus propose only nonoperative treatment (immobilization,
nonsteroidal antiinflammatory medications and activity modification), but majority advocates
operative treatment. Today, arthroscopic bone marrow stimulation involving microfractures is a
primary treatment strategy for symptomatic OCD of the talus. This method is low-cost,
technically undemanding and has low complication rate. Although there is a great number of
good and excellent results published using this method, a progressive deterioration of results over
time has been reported. Our study included 127 cases of OCD of the talus (123 patients) operated
at the Orthopedic Clinic of Cinical Hospital Center Zagreb by microfracture method. Mean
follow-up was 76.5 months (range of months 15 to 177). Large proportion of OCD cases included
and long period of follow-up makes this study a good basis for future research in order to
evaluate long term efficacy of microfracture in treatment of symptomatic OCD of the talus.

• Keywords: Osteohodritis disekans; OCD; talus; mikrofrakture
• Keywords (english): osteochondritis dissecans; OCD; talus; microfracture
• Language: croatian
• URN:NBN: urn:nbn:hr:105:772104
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2015-10-05 11:28:53