Meniscoid Lesion Associated with Childhood Avascular Necrosis

avascular necrosis

There are several reports of meniscoid lesions in patients with chronic ankle injuries, especially in football athletes. Moreover, these lesions are painful and cause impingement of soft tissues. However, this case is one of the first cases to have reported a meniscoid lesion in the ankle joint; due to long-term sequelae of avascular necrosis of the talus development during childhood.

Case Report

A Caucasian 55-year-old male presented to the hospital for consultation. He came with a one-year history of intermittent locking, weight-bearing pain, and swelling above the anterior part of the ankle joint. Furthermore, he was a sedentary work and a non-athlete.

History revealed that he experienced right ankle trauma due to an accidental fall at the age of eight. However, no investigation was done. The pain settled after several months and wasn’t bothersome for the patient until recently.

Examination and Diagnosis

Physical exam revealed pain over the anterior aspect of the joint, without the exhibition of lateral instability. No snap was audible and he experienced pain with a single leg squat. However, there was no difficulty in postural control, no proprioception impairment, or deficiency in strength.

Radiographic imaging showed evident flattening of the posterior region of the talus in association with osteoarthritis of the tibiotalar joint. In addition to osteophytes and subchondral sclerosis with an obvious intraarticular ossicle. Doctors also did a CT anthography of the ankle. It showed a collapse in the talar dome and advanced osteoarthritis with subchondral cysts.

All imaging was significant of avascular necrosis of the talus. Doctors removed it arthroscopically after a conservative treatment approach.

Arthroscopic Debridement

Treatment of meniscoid lesions of the ankle joint is treated successfully with arthroscopic debridement. Moreover, after a two year follow up, the results were satisfactory, despite the presence of advanced osteoarthritis.



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