Isolated Osteochondral defect of the first metatarsal head: A review of surgical treatment options & case report

Osteochondral defects (OCD) are a focal pathology affecting the sub-chondral bone and overlying cartilage. The presence of Osteochondral defects (OCD) within the foot and ankle are well established. Despite this, they are often regarded as an insidious finding, prone to misdiagnosis which can result...

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Main Authors: James Craven, FRCPodS, MSc, Andy Naismith, FRCPodS, BSc
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Foot & Ankle Surgery: Techniques, Reports & Cases
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2667396724000831
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author James Craven, FRCPodS, MSc
Andy Naismith, FRCPodS, BSc
author_facet James Craven, FRCPodS, MSc
Andy Naismith, FRCPodS, BSc
author_sort James Craven, FRCPodS, MSc
collection DOAJ
description Osteochondral defects (OCD) are a focal pathology affecting the sub-chondral bone and overlying cartilage. The presence of Osteochondral defects (OCD) within the foot and ankle are well established. Despite this, they are often regarded as an insidious finding, prone to misdiagnosis which can result in significant debilitation to the affected individual. The mechanisms underlying the formation of these lesions remain disputed. Moreover, the incidence of isolated Osteochondral defects affecting the first Metatarsophalangeal joint in the absence of any additional pathology is unknown.There are a range of surgical treatment modalities described to treat Osteochondral defects. Strategies typically involve cartilage regeneration or replacement of the articular surface: however there are no consensus guidelines regarding the optimum surgical management when applied to the first Metatarsophalangeal joint. The following concepts review aims to explore the literature pertaining to the surgical management of Osteochondral defects including an innovative approach case study employing subchondral drilling technique.Osteochondral defects are managed with a variety of surgical procedures. Surgical outcomes are often derived from literature relating to the knee and hindfoot with little or no study on the forefoot. The included case study demonstrates positive patient satisfaction (PSQ-10) score, improved foot function (MOXFQ) and pain reduction with a novel antegraded Osteochondral drilling technique when applied to the first metatarsal. Further study into the application of contemporary cartilage regeneration and replacement strategies in this location is warranted.
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spelling doaj-art-c19bcc33a10c48be9da72f17a8ea026d2025-08-20T02:06:44ZengElsevierFoot & Ankle Surgery: Techniques, Reports & Cases2667-39672025-01-015110044310.1016/j.fastrc.2024.100443Isolated Osteochondral defect of the first metatarsal head: A review of surgical treatment options & case reportJames Craven, FRCPodS, MSc0Andy Naismith, FRCPodS, BSc1Corresponding author: Sheffield Teaching Hospitals NHS Foundation Trust, Department of Podiatric Surgery, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK.; Sheffield Teaching Hospitals NHS Foundation Trust, UKSheffield Teaching Hospitals NHS Foundation Trust, UKOsteochondral defects (OCD) are a focal pathology affecting the sub-chondral bone and overlying cartilage. The presence of Osteochondral defects (OCD) within the foot and ankle are well established. Despite this, they are often regarded as an insidious finding, prone to misdiagnosis which can result in significant debilitation to the affected individual. The mechanisms underlying the formation of these lesions remain disputed. Moreover, the incidence of isolated Osteochondral defects affecting the first Metatarsophalangeal joint in the absence of any additional pathology is unknown.There are a range of surgical treatment modalities described to treat Osteochondral defects. Strategies typically involve cartilage regeneration or replacement of the articular surface: however there are no consensus guidelines regarding the optimum surgical management when applied to the first Metatarsophalangeal joint. The following concepts review aims to explore the literature pertaining to the surgical management of Osteochondral defects including an innovative approach case study employing subchondral drilling technique.Osteochondral defects are managed with a variety of surgical procedures. Surgical outcomes are often derived from literature relating to the knee and hindfoot with little or no study on the forefoot. The included case study demonstrates positive patient satisfaction (PSQ-10) score, improved foot function (MOXFQ) and pain reduction with a novel antegraded Osteochondral drilling technique when applied to the first metatarsal. Further study into the application of contemporary cartilage regeneration and replacement strategies in this location is warranted.http://www.sciencedirect.com/science/article/pii/S2667396724000831Osteochondral defectOsteochondritis dissecansFirst metatarsalPodiatric SurgeryFootAnkle
spellingShingle James Craven, FRCPodS, MSc
Andy Naismith, FRCPodS, BSc
Isolated Osteochondral defect of the first metatarsal head: A review of surgical treatment options & case report
Foot & Ankle Surgery: Techniques, Reports & Cases
Osteochondral defect
Osteochondritis dissecans
First metatarsal
Podiatric Surgery
Foot
Ankle
title Isolated Osteochondral defect of the first metatarsal head: A review of surgical treatment options & case report
title_full Isolated Osteochondral defect of the first metatarsal head: A review of surgical treatment options & case report
title_fullStr Isolated Osteochondral defect of the first metatarsal head: A review of surgical treatment options & case report
title_full_unstemmed Isolated Osteochondral defect of the first metatarsal head: A review of surgical treatment options & case report
title_short Isolated Osteochondral defect of the first metatarsal head: A review of surgical treatment options & case report
title_sort isolated osteochondral defect of the first metatarsal head a review of surgical treatment options amp case report
topic Osteochondral defect
Osteochondritis dissecans
First metatarsal
Podiatric Surgery
Foot
Ankle
url http://www.sciencedirect.com/science/article/pii/S2667396724000831
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