Osteochondral lesion of talus, ankle impingement, and sinus tarsi syndrome

Abstract

Target of OLT treatment strategies is to relieve symptoms and to improve function, and the choice of treatment is based on the type and size of the defect and on preferences of the treating clinician. 2. Arthroscopic excision, curettage, and bone marrow stimulation procedure (BMSP) is recommended to be the first treatment of choice for primary osteochondral talar lesions. 3. Ankle impingement syndrome, which is diagnosed with MR imaging, is a pathologic condition that produces painful restriction of movement at the tibiotalar joint caused by osseous or soft tissue overgrowth. 4. In the majority of cases, ankle impingement is treated with conservative measures, with surgical debridement by removing bony or soft tissue impediments via arthroscopy or an open procedure, reserved for patients who have refractory symptoms. 5. Four consistent clinical signs associated with sinus tarsi disease have been described: (a) tenderness, (b) instability, (c) relief of pain with a diagnostic block of a local anesthetic, and (d) failure to identify clinical or radiographic evidence of instability. 6. Surgical intervention may be required in cases of conservative treatment failure and consists of evacuation of the contents of sinus tarsi, meanwhile arthroscopy of the subtalar joint could also be advocated for subtalar joint decompression.