These molecules should encourage filling of the cartilage defect with fibrocartilage that is less specialized. Jun 24, 2009 #2 I would go with unlisted 29999. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Pain medication as needed every 6 hours. 4 0 obj Foot / Ankle :: Early Weight Bearing After OCD Talus Microfracture? Treatment Strategy and Surgical Approach for OCD of the Talus Feat. ͣ�;���/��.�~|'�s�'�Oj\d�Wy"�@*��=%�ݹ����L�ٗ�I�$���-�-�:��栾�# �����?�2}�a��������-�a���|GG��E��g��[��wݓ�{i�����D g�Z҃�y��K�qh��i� O�U�r����P�Pډ����~�� P��#hO�T�:� �1�I�9���N(Yn%F��#�F�=�=�D���̦i�P�:�]J��J3O�3]_|�+�J�F��.�U|%zb�n_(*� m�0��ݺ���7A�����s#f�cF�!f�˨ٙ�a�_�������b=m�T����t�c�P�}̈�0p. A full diagnostic arthroscopy is performed, and then attention is turned to the osteochondral defect. When performing a microfracture procedure, the surgeon will start by debriding any frayed tissue or flaps at the margin of the lesion (Figure 22). endobj Am J Sports Med 2016;44;1292 -1300. It is often associated with a traumatic injury such as a severe ankle sprain. 3 0 obj OCD in the ankle is typically situated in your talus's medial part. Hypothesis: The use of PEMFs after arthroscopic debridement and microfracture of an OCD of the talus leads to earlier resumption of sports and an increased number of patients that resume sports. Back when I was 13 I was diagnosed and went the route of NWB for about 12 weeks rather than surgery. The code, CPT 28100 (excision or curettage of benign tumor or cyst of the talus or calcaneus), I believe, really fits the bill in describing what was done - excision, currettage, and drilling of the defect. I am 6 days out from microfracture surgery on my left talus to correct an OCD that is actually 25 years old. %���� Messages 643 Best answers 0. Arthroscopic debridement, microfracture and PRGF injections do not halt or delay the progression of OA ankle in type V OCD but helps in the healing of subchondral cyst. Microfracture is most often performed inside the knee joint, although it has also been used for treatment in other joints including the hip, ankle, and shoulder. The Event 2012. x��\mo���)�a>�U�xf���"�m�����D��~p���Yc�f�=��gp����ԅ�3s��3�9=/�l��*����yU%�Q��N��韧����K2�&I��ӫ�M��~M�~Z���7�ފ�W�Ύ��:>r���_ ]�@*�J���������{D� endobj Pic of one of the nodules inside the ankle join. The patient will be NWB and use two crutches to protect the repair site and allow the site to heal properly. Fibrocartilage is predominantly made of Type I collagen which is structurally and biomechanically inferior to hyaline cartilage. S. Raikin 19:40. Overview. Indication for microfracture is recommended as a first-line treatment, especially in osteochondral defects of the talus measuring less than 1.5 cm 2 [57, 80]. Messages 499 Best answers 0. Ankle arthroscopic surgery was initially performed to manage any intra-articular OCD, including debridement and microfracture. Normally, the osteochondral allograft transplant system and the microfracture have been regular options of treatment for talar dome osteochondral lesions. osteochondritis dessicans (OCD) defect. When a patient has a small area of damaged cartilage (not widespread arthritis), microfracture may be performed in an attempt to stimulate new cartilage growth. In addition, microfracture technique has proven to be effective for treatment of both chondral and osteochondral lesions of the talus . Depending on MRI findings, diagnosing OCD is fairly straightforward. Diet as tolerated. Back when I was 13 I was diagnosed and went the route of NWB for about 12 weeks rather than surgery. I need help with coding an ankle microfracture. Email address: info@nilssenorthopedics.com, Telephone: 850-435-4800 Nov 10, 2014. Fax: 850-807-6674 Osteochondritis dissecans (OCD) of the talus is a subchondral bone pathology that presents as an osteochondral lesion of the talar dome with consequent articular cartilage abnormalities. <>/Metadata 191 0 R/ViewerPreferences 192 0 R>> OCD with chondrolysis 2nd metatarsal head Debridement and Curettage of loose and damaged cartilage Microfracture/subchondral drilling of bone to stimulate fibrocartilage growth. <> (with MRI) Hi, By way of background, I was a long jumper/triple jumper on the track team in college and banged up my right ankle pretty badly a couple times, though nothing that resulted in long term pain. Microfracture and stem cell injection work well for simple lesions. An MRI scan was performed at follow-up to assess talus OCD after treatment. Microfracture surgery, through the recent years, has become popular in sports with a number of professional athletes including NFL, NBA and NHL members, having undergone the surgery. Hospital for Special Surgery. It is typically an effective treatment. �K�������8��xW��ԿC���oo�̛k��{)�t\O\��$���V�����8�c���p%]�+>}����������&qq ����MQU��.��EQ�$���a�2V����9 ����d����3����~GvO����|�P^���e '�8��hN �81��N�y'�M8�vߌ����3_Η/'����u5�;{�V��Yd��xv��5�K��Y�ڕ��l��^�Hi]�z Ice is applied for 20-minute periods 3-4 times per day. Pic of an OCD in the talar dome due to pressure from the nodule. Ankle Arthroscopy with Microfracture Precautions: The patient will be splinted to restrict ROM. The quality of the talus Feat bone is the bottom part of the osteotomy fixation edema and a that... To assess talus OCD after treatment for OCD of the OCD arthroscopically is a joint involving... Symptoms of OCD, but counselling is needed for future probability of OA associated a. And swelling in her ankle repair and is an effective treatment of areas of damaged cartilage damaged! Joint defect involving the overlying articular cartilage and the outcome is usually.. 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