{"id":4549,"date":"2023-01-17T22:09:20","date_gmt":"2023-01-17T22:09:20","guid":{"rendered":"https:\/\/langs.physio-pedia.com\/management-of-ankle-osteochondral-lesions-fr\/"},"modified":"2023-01-26T23:58:19","modified_gmt":"2023-01-26T23:58:19","slug":"management-of-ankle-osteochondral-lesions-fr","status":"publish","type":"page","link":"https:\/\/langs.physio-pedia.com\/fr\/management-of-ankle-osteochondral-lesions-fr\/","title":{"rendered":"Traiter les l\u00e9sions ost\u00e9ochondrales de la cheville"},"content":{"rendered":"<div class=\"mw-parser-output\">\n<div class=\"editorbox\"><b>\u00c9diteur original <\/b>&#8211; <a title=\"User:Ewa Jaraczewska\" href=\"\/User:Ewa_Jaraczewska\">Ewa Jaraczewska<\/a> d&rsquo;apr\u00e8s le cours de <a class=\"external text\" href=\"https:\/\/members.physio-pedia.com\/instructor\/helene-simpson\/\" rel=\"nofollow\">Helene Simpson<\/a><br \/>\n<b>Principaux contributeurs<\/b> &#8211; <a class=\"mw-userlink\" title=\"User:Ewa Jaraczewska\" href=\"\/User:Ewa_Jaraczewska\"><bdi>Ewa Jaraczewska<\/bdi><\/a>, <a class=\"mw-userlink\" title=\"User:Jess Bell\" href=\"\/User:Jess_Bell\"><bdi>Jess Bell<\/bdi><\/a>, <a class=\"mw-userlink\" title=\"User:Lucinda hampton\" href=\"\/User:Lucinda_hampton\"><bdi>Lucinda hampton<\/bdi><\/a> et <a class=\"mw-userlink\" title=\"User:Kim Jackson\" href=\"\/User:Kim_Jackson\"><bdi>Kim Jackson<\/bdi><\/a><\/div>\n<div id=\"toc\" class=\"toc\" role=\"navigation\" aria-labelledby=\"mw-toc-heading\"><input id=\"toctogglecheckbox\" class=\"toctogglecheckbox\" style=\"display: none;\" role=\"button\" type=\"checkbox\"><\/p>\n<div class=\"toctitle\" dir=\"ltr\" lang=\"en\">\n<h2 id=\"mw-toc-heading\">Contenu<\/h2>\n<\/div>\n<ul>\n<li class=\"toclevel-1 tocsection-1\"><a href=\"#Definitions\"><span class=\"tocnumber\">1<\/span> <span class=\"toctext\">D\u00e9finitions<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-2\"><a href=\"#Healing_of_Osteochondral_Lesions\"><span class=\"tocnumber\">2<\/span> <span class=\"toctext\">La gu\u00e9rison des <b>l\u00e9sions ost\u00e9ochondrales<\/b><\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-3\"><a href=\"#Aetiology_of_Osteochondral_Lesions\"><span class=\"tocnumber\">2.1<\/span> <span class=\"toctext\">\u00c9tiologie des <b>l\u00e9sions ost\u00e9ochondrales<\/b><\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-4\"><a href=\"#Osteochondral_Lesions_of_the_Ankle\"><span class=\"tocnumber\">3<\/span> <span class=\"toctext\">Les l\u00e9sions ost\u00e9ochondrales \u00e0 la cheville<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-5\"><a href=\"#Classification_System_for_Osteochondral_Lesions_of_the_Talar_Cartilage\"><span class=\"tocnumber\">3.1<\/span> <span class=\"toctext\">Syst\u00e8me de classification des l\u00e9sions ost\u00e9ochondrales au niveau du talon<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-6\"><a href=\"#Clinical_Presentation\"><span class=\"tocnumber\">4<\/span> <span class=\"toctext\">Pr\u00e9sentation clinique<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-7\"><a href=\"#Diagnostic_Procedures\"><span class=\"tocnumber\">5<\/span> <span class=\"toctext\">Proc\u00e9dures diagnostiques<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-8\"><a href=\"#Outcome_Measures\"><span class=\"tocnumber\">6<\/span> <span class=\"toctext\">Mesures des r\u00e9sultats<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-9\"><a href=\"#Comprehensive_Rehabilitation\"><span class=\"tocnumber\">7<\/span> <span class=\"toctext\">Une r\u00e9adaptation compl\u00e8te<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-10\"><a href=\"#General_principles_in_rehabilitation_management\"><span class=\"tocnumber\">7.1<\/span> <span class=\"toctext\">Principes g\u00e9n\u00e9raux du traitement en r\u00e9adaptation<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-11\"><a href=\"#Special_Concerns\"><span class=\"tocnumber\">7.2<\/span> <span class=\"toctext\">Pr\u00e9occupations particuli\u00e8res<\/span><\/a>\n<ul>\n<li class=\"toclevel-3 tocsection-12\"><a href=\"#Shear_forces\"><span class=\"tocnumber\">7.2.1<\/span> <span class=\"toctext\">Les forces de cisaillement<\/span><\/a><\/li>\n<li class=\"toclevel-3 tocsection-13\"><a href=\"#Compressive_forces\"><span class=\"tocnumber\">7.2.2<\/span> <span class=\"toctext\">Les forces de compression<\/span><\/a><\/li>\n<li class=\"toclevel-3 tocsection-14\"><a href=\"#Slow_Recovery\"><span class=\"tocnumber\">7.2.3<\/span> <span class=\"toctext\">Une r\u00e9cup\u00e9ration lente<\/span><\/a><\/li>\n<li class=\"toclevel-3 tocsection-15\"><a href=\"#Monitor_pain\"><span class=\"tocnumber\">7.2.4<\/span> <span class=\"toctext\">Surveiller la douleur<\/span><\/a><\/li>\n<li class=\"toclevel-3 tocsection-16\"><a href=\"#Compensatory_movements\"><span class=\"tocnumber\">7.2.5<\/span> <span class=\"toctext\">Les mouvements compensatoires<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-2 tocsection-17\"><a href=\"#Ankle_Osteochondral_Lesions_Treatment_Strategies.5B11.5D\"><span class=\"tocnumber\">7.3<\/span> <span class=\"toctext\">Strat\u00e9gies de traitement des l\u00e9sions ost\u00e9ochondrales de la cheville <\/span><sup>(11)<\/sup><\/a>\n<ul>\n<li class=\"toclevel-3 tocsection-18\"><a href=\"#Stage_1\"><span class=\"tocnumber\">7.3.1<\/span> <span class=\"toctext\">\u00c9tape 1<\/span><\/a><\/li>\n<li class=\"toclevel-3 tocsection-19\"><a href=\"#Stage_2\"><span class=\"tocnumber\">7.3.2<\/span> <span class=\"toctext\">\u00c9tape 2<\/span><\/a><\/li>\n<li class=\"toclevel-3 tocsection-20\"><a href=\"#Stage_3\"><span class=\"tocnumber\">7.3.3<\/span> <span class=\"toctext\">\u00c9tape 3<\/span><\/a><\/li>\n<li class=\"toclevel-3 tocsection-21\"><a href=\"#Stage_4\"><span class=\"tocnumber\">7.3.4<\/span> <span class=\"toctext\">\u00c9tape 4<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-22\"><a href=\"#Resources\"><span class=\"tocnumber\">8<\/span> <span class=\"toctext\">Ressources<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-23\"><a href=\"#References\"><span class=\"tocnumber\">9<\/span> <span class=\"toctext\">R\u00e9f\u00e9rences<\/span><\/a><\/li>\n<\/ul>\n<\/div>\n<h2><span id=\"Definitions\" class=\"mw-headline\">D\u00e9finitions<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Definitions\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;veaction=edit&amp;section=1\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Definitions\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;action=edit&amp;section=1\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width: 394px;\"><a class=\"image\" href=\"\/File:Three-types-of-cartilage-hyaline-elastic-and-fibrocartilage.png\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/3\/39\/Three-types-of-cartilage-hyaline-elastic-and-fibrocartilage.png\/392px-Three-types-of-cartilage-hyaline-elastic-and-fibrocartilage.png\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/3\/39\/Three-types-of-cartilage-hyaline-elastic-and-fibrocartilage.png\/588px-Three-types-of-cartilage-hyaline-elastic-and-fibrocartilage.png 1.5x, https:\/\/www.physio-pedia.com\/images\/3\/39\/Three-types-of-cartilage-hyaline-elastic-and-fibrocartilage.png 2x\" alt=\"\" width=\"392\" height=\"296\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Les 3 types de cartilage<\/p>\n<\/div>\n<\/div>\n<\/div>\n<p>Le <a title=\"Cartilage\" href=\"\/Cartilage\">cartilage<\/a> est un tissu conjonctif qui poss\u00e8de les composants suivants : <sup id=\"cite_ref-:3_1-0\" class=\"reference\"><a href=\"#cite_note-:3-1\">(1)<\/a><\/sup><\/p>\n<ul>\n<li>Des polysaccharides (composant cellulaire compos\u00e9 de substance fondamentale<\/li>\n<li>Des prot\u00e9ines fibreuses<\/li>\n<li>Du liquide interstitiel dont l&rsquo;eau est le principal composant<\/li>\n<\/ul>\n<p>Le cartilage se nourrit par diffusion \u00e0 partir des tissus environnants, car il n&rsquo;a pas d&rsquo;apport <a title=\"Blood Physiology\" href=\"\/Blood_Physiology\">sanguin<\/a>, <a title=\"Lymphatic System\" href=\"\/Lymphatic_System\">lymphatique<\/a> ou <a title=\"Neurone\" href=\"\/Neurone\">nerveux <\/a>direct. <sup id=\"cite_ref-:3_1-1\" class=\"reference\"><a href=\"#cite_note-:3-1\">(1)<\/a><\/sup><\/p>\n<p>Il existe trois types de tissus cartilagineux : le cartilage hyalin, le fibrocartilage et le cartilage \u00e9lastique. <sup id=\"cite_ref-:3_1-2\" class=\"reference\"><a href=\"#cite_note-:3-1\">(1)<\/a><\/sup> Chaque type de tissu cartilagineux a une composition et une fonction diff\u00e9rentes :<\/p>\n<ol>\n<li>\n<div class=\"floatright\"><a class=\"image\" href=\"\/File:Extracellular_Matrix_Components_of_Cartilage.jpeg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/4\/42\/Extracellular_Matrix_Components_of_Cartilage.jpeg\/364px-Extracellular_Matrix_Components_of_Cartilage.jpeg\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/4\/42\/Extracellular_Matrix_Components_of_Cartilage.jpeg\/546px-Extracellular_Matrix_Components_of_Cartilage.jpeg 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/4\/42\/Extracellular_Matrix_Components_of_Cartilage.jpeg\/728px-Extracellular_Matrix_Components_of_Cartilage.jpeg 2x\" alt=\"Extracellular Matrix Components of Cartilage.jpeg\" width=\"364\" height=\"199\"><\/a><\/div>\n<p><a title=\"Cartilage\" href=\"\/Cartilage\">Le cartilage hyalin <\/a>: est un tissu conjonctif situ\u00e9 \u00e0 l&rsquo;extr\u00e9mit\u00e9 des os. Ses cellules primaires sont les chondrocytes. Leur r\u00f4le est de maintenir la <a title=\"Extracellular Matrix\" href=\"\/Extracellular_Matrix\">matrice extracellulaire<\/a> du cartilage, qui est responsable de la fonction biologique et m\u00e9canique du cartilage. La matrice extracellulaire du cartilage hyalin contient : <sup id=\"cite_ref-2\" class=\"reference\"><a href=\"#cite_note-2\">(2)<\/a><\/sup><\/p>\n<ul>\n<li><a title=\"Collagen\" href=\"\/Collagen\">Du collag\u00e8ne<\/a> de type II (10-20%)<\/li>\n<li>Des prot\u00e9oglycanes (1-10%)<\/li>\n<li>De l&rsquo;eau (65-85%)<\/li>\n<\/ul>\n<\/li>\n<li>Le <a title=\"Cartilage\" href=\"\/Cartilage\">fibrocartilage<\/a> est un \u00ab\u00a0tissu de transition entre le cartilage hyalin et le tissu conjonctif dense et r\u00e9gulier\u00a0\u00bb. <sup id=\"cite_ref-:3_1-3\" class=\"reference\"><a href=\"#cite_note-:3-1\">(1)<\/a><\/sup> Ce type de tissu peut \u00eatre trouv\u00e9 dans la symphyse pubienne, l&rsquo;anneau fibreux du disque intervert\u00e9bral, les tendons et les ligaments. <sup id=\"cite_ref-3\" class=\"reference\"><a href=\"#cite_note-3\">(3)<\/a><\/sup> Il contient : <sup id=\"cite_ref-:3_1-4\" class=\"reference\"><a href=\"#cite_note-:3-1\">(1)<\/a><\/sup>\n<ul>\n<li>Des niveaux \u00e9lev\u00e9s de collag\u00e8ne de type I<\/li>\n<li>Collag\u00e8ne de type II<\/li>\n<li>Un petit composant de la substance fondamentale<\/li>\n<\/ul>\n<\/li>\n<li><a title=\"Cartilage\" href=\"\/Cartilage\">Le cartilage \u00e9lastique <\/a>: est un cartilage de tissu conjonctif flexible qui peut r\u00e9sister \u00e0 des flexions r\u00e9p\u00e9t\u00e9es. <sup id=\"cite_ref-:3_1-5\" class=\"reference\"><a href=\"#cite_note-:3-1\">(1)<\/a><\/sup> Il est constitu\u00e9 de : <sup id=\"cite_ref-:3_1-6\" class=\"reference\"><a href=\"#cite_note-:3-1\">(1)<\/a><\/sup>\n<ul>\n<li>Collag\u00e8ne de type II<\/li>\n<li>Fibres \u00e9lastiques<\/li>\n<li>Grands chondrocytes<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n<p>L&rsquo;<a title=\"Os\" href=\"\/Bone\">os sous-chondral<\/a> est situ\u00e9 sous le cartilage hyalin et la ligne de s\u00e9paration (c&rsquo;est-\u00e0-dire la limite entre le cartilage calcifi\u00e9 et l&rsquo;<a title=\"Os\" href=\"\/Bone\">os<\/a> sous-chondral <sup id=\"cite_ref-3\" class=\"reference\"><a href=\"#cite_note-3\">(3)<\/a><\/sup>). Il est responsable du soutien m\u00e9canique (y compris l&rsquo;absorption des chocs) et nutritionnel au cartilage (l&rsquo;os sous-chondral contenant des vaisseaux qui interagissent directement avec la couche de cartilage hyalin). <sup id=\"cite_ref-4\" class=\"reference\"><a href=\"#cite_note-4\">(4)<\/a><\/sup> Le m\u00e9canisme de perfusion des vaisseaux osseux sous-chondraux est responsable de la distribution de 50 % des nutriments au cartilage.<sup id=\"cite_ref-5\" class=\"reference\"><a href=\"#cite_note-5\">(5)<\/a><\/sup><\/p>\n<p>Les <b>l\u00e9sions ost\u00e9ochondrales<\/b> sont des d\u00e9faillances affectant la structure de la surface cartilagineuse et de l&rsquo;os sous-chondral sous-jacent. Lorsque la phase de gu\u00e9rison de la l\u00e9sion commence et qu&rsquo;un tissu se forme, le nouveau tissu est souvent un fibrocartilage. Ce type de cartilage pr\u00e9sente des inconv\u00e9nients m\u00e9caniques par rapport au cartilage hyalin. Dans certains cas, un cartilage hyalin se forme pendant le processus de r\u00e9paration. Le m\u00e9canisme de formation du cartilage hyalin par rapport au cartilage fibreux est inconnu.<sup id=\"cite_ref-:3_1-7\" class=\"reference\"><a href=\"#cite_note-:3-1\">(1)<\/a><\/sup><\/p>\n<h2><span id=\"Healing_of_Osteochondral_Lesions\" class=\"mw-headline\">La gu\u00e9rison des <b>l\u00e9sions ost\u00e9ochondrales <\/b><\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Healing of Osteochondral Lesions\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;veaction=edit&amp;section=2\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Healing of Osteochondral Lesions\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;action=edit&amp;section=2\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Les l\u00e9sions ost\u00e9ochondrales ont une faible capacit\u00e9 de gu\u00e9rison. <sup id=\"cite_ref-:4_6-0\" class=\"reference\"><a href=\"#cite_note-:4-6\">(6)<\/a><\/sup> Une \u00e9tude compl\u00e9t\u00e9e chez les animaux <sup id=\"cite_ref-7\" class=\"reference\"><a href=\"#cite_note-7\">(7)<\/a><\/sup> d\u00e9montre que les l\u00e9sions ost\u00e9ochondrales passent par les \u00e9tapes suivantes de gu\u00e9rison : <sup id=\"cite_ref-:4_6-1\" class=\"reference\"><a href=\"#cite_note-:4-6\">(6)<\/a><\/sup><\/p>\n<ul>\n<li>Semaine 1 \u00e0 2 : r\u00e9paration initiale par la fibrine &#8211; le site endommag\u00e9 commence \u00e0 se remplir d&rsquo;un caillot de sang et de tissu fibreux, le recrutement de cellules m\u00e9senchymateuses commence.<\/li>\n<li>Semaine 4 \u00e0 8 : La formation de cartilage commence autour du cartilage endommag\u00e9.<\/li>\n<li>Semaines 8 \u00e0 12 : la formation osseuse commence par l&rsquo;ossification endochondrale.<\/li>\n<li>Semaine 18 : La formation de nouvel os se poursuit<\/li>\n<li>Semaine 26 : Ach\u00e8vement du processus de gu\u00e9rison<\/li>\n<\/ul>\n<h3><span id=\"Aetiology_of_Osteochondral_Lesions\" class=\"mw-headline\">\u00c9tiologie des <b>l\u00e9sions ost\u00e9ochondrales <\/b><\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Aetiology of Osteochondral Lesions\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;veaction=edit&amp;section=3\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Aetiology of Osteochondral Lesions\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;action=edit&amp;section=3\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Les l\u00e9sions ost\u00e9ochondrales peuvent \u00eatre caus\u00e9es par :<\/p>\n<ul>\n<li>Un traumatisme (80% des cas) <sup id=\"cite_ref-:5_8-0\" class=\"reference\"><a href=\"#cite_note-:5-8\">(8)<\/a><\/sup><\/li>\n<li>Un mauvais alignement des articulations <sup id=\"cite_ref-:0_9-0\" class=\"reference\"><a href=\"#cite_note-:0-9\">(9)<\/a><\/sup><\/li>\n<li>Une <a title=\"Ligament\" href=\"\/Ligament\">laxit\u00e9 ligamentaire<\/a> anormale (38% des patients) <sup id=\"cite_ref-:5_8-1\" class=\"reference\"><a href=\"#cite_note-:5-8\">(8)<\/a><\/sup><\/li>\n<li>Une instabilit\u00e9 (39% des patients) <sup id=\"cite_ref-:5_8-2\" class=\"reference\"><a href=\"#cite_note-:5-8\">(8)<\/a><\/sup><\/li>\n<li><a title=\"Genetics and Health\" href=\"\/Genetics_and_Health\">Une pr\u00e9disposition g\u00e9n\u00e9tique <\/a><sup id=\"cite_ref-:0_9-1\" class=\"reference\"><a href=\"#cite_note-:0-9\">(9)<\/a><\/sup><\/li>\n<li>Des <a class=\"mw-redirect\" title=\"Endocrine Disorders\" href=\"\/Endocrine_Disorders\">facteurs endocriniens<\/a> <sup id=\"cite_ref-:5_8-3\" class=\"reference\"><a href=\"#cite_note-:5-8\">(8) <\/a><\/sup><sup id=\"cite_ref-:0_9-2\" class=\"reference\"><a href=\"#cite_note-:0-9\">(9)<\/a><\/sup><\/li>\n<li><a title=\"Avascular Necrosis\" href=\"\/Avascular_Necrosis\">Une n\u00e9crose avasculaire <\/a><sup id=\"cite_ref-:0_9-3\" class=\"reference\"><a href=\"#cite_note-:0-9\">(9)<\/a><\/sup><\/li>\n<li>Des facteurs m\u00e9taboliques <sup id=\"cite_ref-:5_8-4\" class=\"reference\"><a href=\"#cite_note-:5-8\">(8)<\/a><\/sup><\/li>\n<\/ul>\n<p>Trois types de traumatismes conduisent au d\u00e9veloppement de l\u00e9sions ost\u00e9ochondrales : la compression, le cisaillement ou l&rsquo;avulsion.<\/p>\n<h2><span id=\"Osteochondral_Lesions_of_the_Ankle\" class=\"mw-headline\">Les l\u00e9sions ost\u00e9ochondrales \u00e0 la cheville <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Osteochondral Lesions of the Ankle\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;veaction=edit&amp;section=4\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Osteochondral Lesions of the Ankle\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;action=edit&amp;section=4\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width: 302px;\"><a class=\"image\" href=\"\/File:Osteochondral-injury-of-talus-staging-illustration.png\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/a\/ab\/Osteochondral-injury-of-talus-staging-illustration.png\/300px-Osteochondral-injury-of-talus-staging-illustration.png\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/a\/ab\/Osteochondral-injury-of-talus-staging-illustration.png\/450px-Osteochondral-injury-of-talus-staging-illustration.png 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/a\/ab\/Osteochondral-injury-of-talus-staging-illustration.png\/600px-Osteochondral-injury-of-talus-staging-illustration.png 2x\" alt=\"\" width=\"300\" height=\"300\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>L\u00e9sions ost\u00e9ochondrales du talus : Stades<\/p>\n<\/div>\n<\/div>\n<\/div>\n<p>Selon Ferkel et al, <sup id=\"cite_ref-10\" class=\"reference\"><a href=\"#cite_note-10\">(10)<\/a><\/sup> un pourcentage \u00e9lev\u00e9 de patients pr\u00e9sentant une <a title=\"Chronic Ankle Instability\" href=\"\/Chronic_Ankle_Instability\">instabilit\u00e9 lat\u00e9rale de la cheville<\/a> d\u00e9veloppent une pathologie intra-articulaire. Dans l&rsquo;<a title=\"Ankle and Foot\" href=\"\/Ankle_and_Foot\">articulation de la cheville<\/a>, les l\u00e9sions ost\u00e9ochondrales se produisent dans le <a title=\"Le talus\" href=\"\/Talus\">talus (anc. astragale)<\/a>. Les l\u00e9sions du cartilage du talus et de son os sous-chondral peuvent entra\u00eener un d\u00e9tachement partiel ou complet du fragment. Les l\u00e9sions ost\u00e9ochondrales peuvent \u00eatre caract\u00e9ris\u00e9s comme suit :<\/p>\n<ul>\n<li>Chondrale (cartilage uniquement)<\/li>\n<li>Chondrale-subchondrale (cartilage et os)<\/li>\n<li>Subchondrale (cartilage sus-jacent intact)<\/li>\n<li>Cystique<\/li>\n<li>Stable ou instable<\/li>\n<li>Non d\u00e9plac\u00e9s ou d\u00e9plac\u00e9s<\/li>\n<\/ul>\n<h3><span id=\"Classification_System_for_Osteochondral_Lesions_of_the_Talar_Cartilage\" class=\"mw-headline\">Syst\u00e8me de classification des l\u00e9sions ost\u00e9ochondrales au niveau du talon <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Classification System for Osteochondral Lesions of the Talar Cartilage\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;veaction=edit&amp;section=5\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Classification System for Osteochondral Lesions of the Talar Cartilage\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;action=edit&amp;section=5\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Les syst\u00e8mes de classification des l\u00e9sions ost\u00e9ochondrales suivants sont utilis\u00e9s, principalement pour la recherche. Cliniquement, les facteurs les plus importants sont la localisation et la profondeur des l\u00e9sions. En g\u00e9n\u00e9ral, plus la l\u00e9sion est grande, plus elle devient probl\u00e9matique.<sup id=\"cite_ref-:6_11-0\" class=\"reference\"><a href=\"#cite_note-:6-11\">(11)<\/a><\/sup><\/p>\n<ul>\n<li>Le Berndt et Harty<sup id=\"cite_ref-12\" class=\"reference\"><a href=\"#cite_note-12\">(12)<\/a><\/sup> reste le syst\u00e8me le plus couramment utilis\u00e9 pour classer les l\u00e9sions ost\u00e9ochondrales radiographiques. Ce syst\u00e8me est comme suit : <sup id=\"cite_ref-:1_13-0\" class=\"reference\"><a href=\"#cite_note-:1-13\">(13)<\/a><\/sup>\n<ul>\n<li>Stade I : le pied \u00e9tant en position invers\u00e9e, le bord lat\u00e9ral est comprim\u00e9 contre la face de la fibula (p\u00e9ron\u00e9), et le ligament collat\u00e9ral reste intact<\/li>\n<li>Stade II : avec l&rsquo;inversion progressive du pied, le ligament lat\u00e9ral est rompu et l&rsquo;avulsion du fragment commence<\/li>\n<li>Stade III : le fragment est enti\u00e8rement d\u00e9tach\u00e9e mais reste en place<\/li>\n<li>Stade IV : le d\u00e9placement d&rsquo;un fragment d\u00e9tach\u00e9 se produit suite \u00e0 l&rsquo;inversion<\/li>\n<\/ul>\n<\/li>\n<li>Loomer et al. <sup id=\"cite_ref-14\" class=\"reference\"><a href=\"#cite_note-14\">(14)<\/a><\/sup> ont ajout\u00e9 un cinqui\u00e8me stade au syst\u00e8me de classification de Berndt et Harty : <sup id=\"cite_ref-:1_13-1\" class=\"reference\"><a href=\"#cite_note-:1-13\">(13)<\/a><\/sup>\n<ul>\n<li>Stade I \u00e0 IV comme ci-dessus<\/li>\n<li>Stade V : pr\u00e9sence d&rsquo;un kyste sous-chondral<\/li>\n<\/ul>\n<\/li>\n<li>Ferkel et al. <sup id=\"cite_ref-15\" class=\"reference\"><a href=\"#cite_note-15\">(15)<\/a><\/sup> ont d\u00e9velopp\u00e9 un syst\u00e8me de classification bas\u00e9 sur la tomodensitom\u00e9trie (CT scan) : <sup id=\"cite_ref-:2_16-0\" class=\"reference\"><a href=\"#cite_note-:2-16\">(16)<\/a><\/sup>\n<ul>\n<li>Stade I : L\u00e9sion kystique dans le d\u00f4me du talus (astragale) (le toit est intact)<\/li>\n<li>Stade IIa : L\u00e9sion kystique avec communication avec la surface du d\u00f4me du talus.<\/li>\n<li>Stade IIb : L\u00e9sion ouverte de la surface articulaire avec un fragment non d\u00e9plac\u00e9 sus-jacent.<\/li>\n<li>Stade III : L\u00e9sion non d\u00e9plac\u00e9e avec transparence.<\/li>\n<li>Stade IV : fragment d\u00e9plac\u00e9<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Hepple et al. <sup id=\"cite_ref-17\" class=\"reference\"><a href=\"#cite_note-17\">(17)<\/a><\/sup> ont d\u00e9velopp\u00e9 un syst\u00e8me de classification bas\u00e9 sur l&rsquo;imagerie par r\u00e9sonance magn\u00e9tique (IRM) : <sup id=\"cite_ref-:2_16-1\" class=\"reference\"><a href=\"#cite_note-:2-16\">(16)<\/a><\/sup><\/li>\n<\/ul>\n<div class=\"center\">\n<div class=\"thumb tnone\">\n<div class=\"thumbinner\" style=\"width: 502px;\"><a class=\"image\" href=\"\/File:OCL_MRI_classification.png\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/7\/7e\/OCL_MRI_classification.png\/500px-OCL_MRI_classification.png\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/7\/7e\/OCL_MRI_classification.png\/750px-OCL_MRI_classification.png 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/7\/7e\/OCL_MRI_classification.png\/1000px-OCL_MRI_classification.png 2x\" alt=\"\" width=\"500\" height=\"368\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p><small>Classification IRM des l\u00e9sions ost\u00e9ochondrales. Adapt\u00e9 de AA, Sesin C, Rosselli M. Osteochondral defects of the talus with a focus on platelet-rich plasma as a potential treatment option : a review. BMJ Open Sport Exerc Med. 2018 Feb 1;4(1):e000318.<\/small><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<h2><span id=\"Clinical_Presentation\" class=\"mw-headline\">Pr\u00e9sentation clinique <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Clinical Presentation\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;veaction=edit&amp;section=6\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Clinical Presentation\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;action=edit&amp;section=6\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Les patients pr\u00e9sentant des l\u00e9sions ost\u00e9ochondrales de la cheville signalent une douleur profonde de la cheville associ\u00e9e \u00e0 la mise en charge, une limitation de l&rsquo;amplitude des mouvements, une alt\u00e9ration de la fonction, une raideur et une sensation d&rsquo;accrochage et de blocage. De plus, le patient peut ressentir une sensibilit\u00e9 et un gonflement autour de la cheville m\u00e9diale et lat\u00e9rale. <sup id=\"cite_ref-:5_8-5\" class=\"reference\"><a href=\"#cite_note-:5-8\">(8)<\/a><\/sup> L&rsquo;examen r\u00e9v\u00e8le souvent une restriction de l&rsquo;amplitude de mouvements des articulations subtalaire et talo-naviculaire, une alt\u00e9ration de la stabilit\u00e9 ligamentaire de la cheville et un mauvais alignement de l&rsquo;arri\u00e8re-pied. <sup id=\"cite_ref-:1_13-2\" class=\"reference\"><a href=\"#cite_note-:1-13\">(13)<\/a><\/sup> <sup id=\"cite_ref-:5_8-6\" class=\"reference\"><a href=\"#cite_note-:5-8\">(8)<\/a><\/sup><\/p>\n<h2><span id=\"Diagnostic_Procedures\" class=\"mw-headline\">Proc\u00e9dures diagnostiques <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Diagnostic Procedures\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;veaction=edit&amp;section=7\">modifier<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Diagnostic Procedures\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;action=edit&amp;section=7\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<ul>\n<li><a title=\"X-Rays\" href=\"\/X-Rays\">La radiographie<\/a> &#8211; vues ant\u00e9ro-post\u00e9rieures (AP) et lat\u00e9rales r\u00e9alis\u00e9es en position de mise en charge <sup id=\"cite_ref-:5_8-7\" class=\"reference\"><a href=\"#cite_note-:5-8\">(8)<\/a><\/sup><\/li>\n<li>L&rsquo;<a title=\"MRI Scans\" href=\"\/MRI_Scans\">IRM<\/a> capture l&rsquo;int\u00e9grit\u00e9 des tissus mous et de l&rsquo;os spongieux sous-chondral <sup id=\"cite_ref-18\" class=\"reference\"><a href=\"#cite_note-18\">(18)<\/a><\/sup><\/li>\n<li>Le <a title=\"CT Scans\" href=\"\/CT_Scans\">CT scan (tomodensitom\u00e9trie)<\/a> offre une meilleure r\u00e9solution pour montrer les pathologies osseuses mais fournit moins d&rsquo;informations sur les tissus mous et l&rsquo;usure du cartilage articulaire <sup id=\"cite_ref-:5_8-8\" class=\"reference\"><a href=\"#cite_note-:5-8\">(8)<\/a><\/sup><\/li>\n<li>La TEMP (tomographie par \u00e9mission monophotonique) est capable de fournir des informations provenant \u00e0 la fois de l&rsquo;IRM et de la TDM (tomodensitom\u00e9trie) ; il est important de prendre en compte la quantit\u00e9 de radiation \u00e0 laquelle le patient est expos\u00e9 avec la TEMP <sup id=\"cite_ref-:5_8-9\" class=\"reference\"><a href=\"#cite_note-:5-8\">(8)<\/a><\/sup><\/li>\n<li>L&rsquo;arthroscopie de la cheville permet une visualisation directe de l&rsquo;ensemble de l&rsquo;articulation <sup id=\"cite_ref-:5_8-10\" class=\"reference\"><a href=\"#cite_note-:5-8\">(8)<\/a><\/sup><\/li>\n<\/ul>\n<h2><span id=\"Outcome_Measures\" class=\"mw-headline\">Mesures des r\u00e9sultats <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Outcome Measures\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;veaction=edit&amp;section=8\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Outcome Measures\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;action=edit&amp;section=8\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<ul>\n<li><a title=\"Lower Extremity Functional Scale (LEFS)\" href=\"\/Lower_Extremity_Functional_Scale_(LEFS)\">Lower Extremity Functional Scale<\/a> (LEFS)<\/li>\n<li><a title=\"Foot and Ankle Ability Measure\" href=\"\/Foot_and_Ankle_Ability_Measure\">\u00c9valuation des capacit\u00e9s fonctionnelles du pied et de la cheville<\/a> (FAAM &#8211; de l&rsquo;anglais Foot and Ankle Ability Measure )<\/li>\n<li><a class=\"external text\" href=\"http:\/\/www.orthoscores.com\/scorepages\/foot_and_ankle_disability_index_fadi.html\" rel=\"nofollow\">The Foot &amp; Ankle Disability Index Score<\/a> (FADI)<\/li>\n<li>Le <a title=\"Foot Function Index (FFI)\" href=\"\/Foot_Function_Index_(FFI)\">Foot Function Index<\/a> (FFI)<\/li>\n<\/ul>\n<h2><span id=\"Comprehensive_Rehabilitation\" class=\"mw-headline\">Une r\u00e9habilitation compl\u00e8te <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Comprehensive Rehabilitation\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;veaction=edit&amp;section=9\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Comprehensive Rehabilitation\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;action=edit&amp;section=9\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<h3><span id=\"General_principles_in_rehabilitation_management\" class=\"mw-headline\">Principes g\u00e9n\u00e9raux du traitement en r\u00e9adaptation <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: General principles in rehabilitation management\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;veaction=edit&amp;section=10\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: General principles in rehabilitation management\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;action=edit&amp;section=10\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Il existe un manque de donn\u00e9es probantes de haute qualit\u00e9 concernant un protocole de traitement sp\u00e9cifique pour la gestion des l\u00e9sions ost\u00e9ochondrales de la cheville. <sup id=\"cite_ref-:6_11-1\" class=\"reference\"><a href=\"#cite_note-:6-11\">(11)<\/a><\/sup> Par cons\u00e9quent, lorsqu&rsquo;il \u00e9tablit les objectifs, planifie le traitement et choisit les interventions, le clinicien doit tenir compte des phases biologiques de la gu\u00e9rison. La r\u00e9adaptation d\u00e9pendra \u00e9galement de la taille de la l\u00e9sion et de sa localisation. En g\u00e9n\u00e9ral, le programme de r\u00e9adaptation doit : <sup id=\"cite_ref-:6_11-2\" class=\"reference\"><a href=\"#cite_note-:6-11\">(11)<\/a><\/sup><\/p>\n<ul>\n<li>\u00catre complet et inclure un entra\u00eenement fonctionnel multimodal<\/li>\n<li>Inclure un minimum de six semaines d&rsquo;entra\u00eenement en r\u00e9adaptation supervis\u00e9e<\/li>\n<li>S&rsquo;occuper du contr\u00f4le postural, de l&rsquo;<a title=\"Balance Training\" href=\"\/Balance_Training\">\u00e9quilibre<\/a> et de la <a title=\"Proprioception\" href=\"\/Proprioception\">proprioception<\/a><\/li>\n<li>Incorporer l&rsquo;ensemble de la <a title=\"Kinetic Chain\" href=\"\/Kinetic_Chain\">cha\u00eene cin\u00e9tique<\/a> pour am\u00e9liorer la <a title=\"Strength Training\" href=\"\/Strength_Training\">force<\/a> globale<\/li>\n<li>Inclure des activit\u00e9s pour maintenir les<a title=\"Range of Motion\" href=\"\/Range_of_Motion\">amplitude de mouvement<\/a><\/li>\n<li>Inclure des mesures pour prot\u00e9ger l&rsquo;articulation de la cheville en faisant porter au patient une orth\u00e8se \u00e0 lacets<\/li>\n<li>Continuer \u00e0 surveiller le patient pendant une p\u00e9riode pouvant aller jusqu&rsquo;\u00e0 deux ans afin d\u00e9tecter une augmentation inexpliqu\u00e9e de la douleur.<\/li>\n<\/ul>\n<h3><span id=\"Special_Concerns\" class=\"mw-headline\">Pr\u00e9occupations particuli\u00e8res <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Special Concerns\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;veaction=edit&amp;section=11\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Special Concerns\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;action=edit&amp;section=11\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Lors du traitement des l\u00e9sions ost\u00e9ochondrales de la cheville, il est important d&rsquo;appliquer les consid\u00e9rations de r\u00e9adaptation suivantes : <sup id=\"cite_ref-:6_11-3\" class=\"reference\"><a href=\"#cite_note-:6-11\">(11)<\/a><\/sup><\/p>\n<ol>\n<li><b>\u00c9viter les forces de cisaillement<\/b><\/li>\n<li><b>\u00c9viter les forces de compression<\/b><\/li>\n<li><b>Un rythme ad\u00e9quat des activit\u00e9s est n\u00e9cessaire en raison d&rsquo;une r\u00e9cup\u00e9ration lente<\/b><\/li>\n<li><b>Surveiller la douleur<\/b><\/li>\n<li><b>Pr\u00e9venir le d\u00e9veloppement de mouvements compensatoires<\/b><\/li>\n<\/ol>\n<h4><span id=\"Shear_forces\" class=\"mw-headline\">Les forces de cisaillement <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Shear forces\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;veaction=edit&amp;section=12\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Shear forces\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;action=edit&amp;section=12\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<p>Les forces de cisaillement sont souvent la cause sous-jacente des l\u00e9sions ost\u00e9ochondrales avec l&rsquo;instabilit\u00e9 chronique de la cheville<\/p>\n<blockquote><p>\u00c9vitez les forces de cisaillement pendant plus de trois mois<sup id=\"cite_ref-:6_11-4\" class=\"reference\"><a href=\"#cite_note-:6-11\">(11)<\/a><\/sup><\/p><\/blockquote>\n<h4><span id=\"Compressive_forces\" class=\"mw-headline\">Les forces de compression <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Compressive forces\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;veaction=edit&amp;section=13\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Compressive forces\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;action=edit&amp;section=13\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<p>Le fibrocartilage n&rsquo;est pas aussi solide que le cartilage hyalin<\/p>\n<blockquote><p>Retardez la <a title=\"Weight bearing\" href=\"\/Weight_bearing\">mise en charge<\/a> compl\u00e8te jusqu&rsquo;\u00e0 six semaines, en fonction de facteurs cliniques sp\u00e9cifiques <sup id=\"cite_ref-:6_11-5\" class=\"reference\"><a href=\"#cite_note-:6-11\">(11)<\/a><\/sup><\/p><\/blockquote>\n<h4><span id=\"Slow_Recovery\" class=\"mw-headline\">Une r\u00e9cup\u00e9ration lente <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Slow Recovery\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;veaction=edit&amp;section=14\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Slow Recovery\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;action=edit&amp;section=14\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<p>La r\u00e9paration du cartilage prend du temps<\/p>\n<blockquote><p>Allez-y doucement avec les \u00e9tapes 1 et 2 et maintenez une mise en charge partielle<sup id=\"cite_ref-:6_11-6\" class=\"reference\"><a href=\"#cite_note-:6-11\">(11)<\/a><\/sup><\/p><\/blockquote>\n<h4><span id=\"Monitor_pain\" class=\"mw-headline\">Surveiller la douleur <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Monitor pain\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;veaction=edit&amp;section=15\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Monitor pain\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;action=edit&amp;section=15\">modifier la source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<blockquote><p>Individualisez le traitement et respectez la <a title=\"L'\u00e9valuation de la douleur\" href=\"\/Pain_Assessment\">douleur<\/a> du patient <sup id=\"cite_ref-:6_11-7\" class=\"reference\"><a href=\"#cite_note-:6-11\">(11)<\/a><\/sup><\/p><\/blockquote>\n<h4><span id=\"Compensatory_movements\" class=\"mw-headline\">Mouvements compensatoires <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Compensatory movements\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;veaction=edit&amp;section=16\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Compensatory movements\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;action=edit&amp;section=16\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<blockquote><p>Corrigez les sch\u00e9mas moteurs d\u00e9faillants<sup id=\"cite_ref-:6_11-8\" class=\"reference\"><a href=\"#cite_note-:6-11\">(11)<\/a><\/sup><\/p><\/blockquote>\n<h3><span id=\"Ankle_Osteochondral_Lesions_Treatment_Strategies(11)\"><\/span><span id=\"Ankle_Osteochondral_Lesions_Treatment_Strategies.5B11.5D\" class=\"mw-headline\">Strat\u00e9gies de traitement des l\u00e9sions ost\u00e9ochondrales de la cheville <sup id=\"cite_ref-:6_11-9\" class=\"reference\"><a href=\"#cite_note-:6-11\">(11) <\/a><\/sup><\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Ankle Osteochondral Lesions Treatment Strategies(11)\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;veaction=edit&amp;section=17\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Ankle Osteochondral Lesions Treatment Strategies(11)\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;action=edit&amp;section=17\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<h4><span id=\"Stage_1\" class=\"mw-headline\">\u00c9tape 1 <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Stage 1\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;veaction=edit&amp;section=18\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Stage 1\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;action=edit&amp;section=18\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<ul>\n<li>Allez-y DOUCEMENT<\/li>\n<li>Bougez les articulations talo-crurales, mais NE les exposez PAS \u00e0 des forces de compression ou de cisaillement<\/li>\n<li>Incorporez des exercices cardiovasculaires<\/li>\n<li>Maintenez une mise en charge partielle<\/li>\n<\/ul>\n<p>Exemples d&rsquo;exercices :<\/p>\n<ul class=\"gallery mw-gallery-traditional\">\n<li class=\"gallerybox\" style=\"width: 285px;\">\n<div style=\"width: 285px;\">\n<div class=\"thumb\" style=\"width: 280px;\">\n<div style=\"margin: 150px auto;\"><a class=\"image\" href=\"\/File:OCL_stage_1.png\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/4\/4f\/OCL_stage_1.png\/250px-OCL_stage_1.png\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/4\/4f\/OCL_stage_1.png\/375px-OCL_stage_1.png 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/4\/4f\/OCL_stage_1.png\/500px-OCL_stage_1.png 2x\" alt=\"\" width=\"250\" height=\"80\"><\/a><\/div>\n<\/div>\n<div class=\"gallerytext\">\n<p>Exercices doux de dorsiflexion et de flexion plantaire de la cheville<\/p>\n<\/div>\n<\/div>\n<\/li>\n<li class=\"gallerybox\" style=\"width: 285px;\">\n<div style=\"width: 285px;\">\n<div class=\"thumb\" style=\"width: 280px;\">\n<div style=\"margin: 134px auto;\"><a class=\"image\" href=\"\/File:OCL.png\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/0\/00\/OCL.png\/250px-OCL.png\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/0\/00\/OCL.png\/375px-OCL.png 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/0\/00\/OCL.png\/500px-OCL.png 2x\" alt=\"\" width=\"250\" height=\"112\"><\/a><\/div>\n<\/div>\n<div class=\"gallerytext\">\n<p>Exercices des membres inf\u00e9rieurs en appui partiel et alignement ad\u00e9quat<\/p>\n<\/div>\n<\/div>\n<\/li>\n<\/ul>\n<h4><span id=\"Stage_2\" class=\"mw-headline\">\u00c9tape 2 <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Stage 2\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;veaction=edit&amp;section=19\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Stage 2\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;action=edit&amp;section=19\">modifier la source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<ul>\n<li>Cette phase se concentre sur la fonction<\/li>\n<li>Elle est consid\u00e9r\u00e9e comme une phase de pr\u00e9participation<\/li>\n<li>Concentrez-vous sur les d\u00e9tails<\/li>\n<li>Passez d&rsquo;une mise en charge partielle \u00e0 une mise en charge compl\u00e8te en se tenant sur deux pieds<\/li>\n<li>Progressez la mise en charge et la complexit\u00e9 du mouvement<\/li>\n<\/ul>\n<p>Exemple d&rsquo;exercices :<\/p>\n<ul class=\"gallery mw-gallery-traditional\">\n<li class=\"gallerybox\" style=\"width: 285px;\">\n<div style=\"width: 285px;\">\n<div class=\"thumb\" style=\"width: 280px;\">\n<div style=\"margin: 100px auto;\"><a class=\"image\" href=\"\/File:Phase_2_OCL.png\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/c\/cf\/Phase_2_OCL.png\/250px-Phase_2_OCL.png\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/c\/cf\/Phase_2_OCL.png\/375px-Phase_2_OCL.png 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/c\/cf\/Phase_2_OCL.png\/500px-Phase_2_OCL.png 2x\" alt=\"\" width=\"250\" height=\"180\"><\/a><\/div>\n<\/div>\n<div class=\"gallerytext\">\n<p>Progression vers la mise en charge compl\u00e8te avec un alignement ad\u00e9quat<\/p>\n<\/div>\n<\/div>\n<\/li>\n<\/ul>\n<h4><span id=\"Stage_3\" class=\"mw-headline\">\u00c9tape 3 <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Stage 3\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;veaction=edit&amp;section=20\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Stage 3\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;action=edit&amp;section=20\">modifier la source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<ul>\n<li>Activit\u00e9s de remise en forme<\/li>\n<\/ul>\n<p>Exemples d&rsquo;exercices :<\/p>\n<ul class=\"gallery mw-gallery-traditional\">\n<li class=\"gallerybox\" style=\"width: 285px;\">\n<div style=\"width: 285px;\">\n<div class=\"thumb\" style=\"width: 280px;\">\n<div style=\"margin: 16.5px auto;\"><a class=\"image\" href=\"\/File:Phase_3_OCL.png\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/4\/43\/Phase_3_OCL.png\/250px-Phase_3_OCL.png\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/4\/43\/Phase_3_OCL.png\/375px-Phase_3_OCL.png 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/4\/43\/Phase_3_OCL.png\/500px-Phase_3_OCL.png 2x\" alt=\"\" width=\"250\" height=\"347\"><\/a><\/div>\n<\/div>\n<div class=\"gallerytext\">\n<p>Exercices bas\u00e9s sur le test d&rsquo;\u00e9quilibre \u00e0 excursion en \u00e9toile<\/p>\n<\/div>\n<\/div>\n<\/li>\n<li class=\"gallerybox\" style=\"width: 285px;\">\n<div style=\"width: 285px;\">\n<div class=\"thumb\" style=\"width: 280px;\">\n<div style=\"margin: 97.5px auto;\"><a class=\"image\" href=\"\/File:Phase_III_ocl.png\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/a\/a6\/Phase_III_ocl.png\/250px-Phase_III_ocl.png\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/a\/a6\/Phase_III_ocl.png\/375px-Phase_III_ocl.png 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/a\/a6\/Phase_III_ocl.png\/500px-Phase_III_ocl.png 2x\" alt=\"\" width=\"250\" height=\"185\"><\/a><\/div>\n<\/div>\n<div class=\"gallerytext\">\n<p>Activit\u00e9s physiques : step down\/step up<\/p>\n<\/div>\n<\/div>\n<\/li>\n<\/ul>\n<blockquote><p><i>Avant de passer \u00e0 l&rsquo;\u00e9tape 4, le patient doit :<\/i><\/p>\n<ul>\n<li><i>Obtenir de bons r\u00e9sultats \u00e0 leur test d&rsquo;\u00e9quilibre \u00e0 excursion en \u00e9toile <a title=\"Star Excursion Balance Test\" href=\"\/Star_Excursion_Balance_Test\">(Star Excursion Balance Test &#8211; SEBT)<\/a><\/i><\/li>\n<li><i>Avoir une amplitude compl\u00e8te de dorsiflexion en mise en charge sans douleur<\/i><\/li>\n<li><i>Effectuer un test de saut simple sans douleur et en conservant un bon alignement<\/i><\/li>\n<li><i>D\u00e9montrer un contr\u00f4le moteur raisonnable dans le mouvement m\u00e9dian post\u00e9rieur<\/i><\/li>\n<\/ul>\n<\/blockquote>\n<h4><span id=\"Stage_4\" class=\"mw-headline\">\u00c9tape 4 <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Stage 4\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;veaction=edit&amp;section=21\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Stage 4\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;action=edit&amp;section=21\">modifier la source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<ul>\n<li><a class=\"external text\" href=\"https:\/\/blog.nasm.org\/fitness\/developing-power-in-everyday-athletes-with-plyometrics\" rel=\"nofollow\">Exercices de plyom\u00e9trie<\/a><\/li>\n<\/ul>\n<h2><span id=\"Resources\" class=\"mw-headline\">Ressources<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Resources\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;veaction=edit&amp;section=22\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Resources\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;action=edit&amp;section=22\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<ol>\n<li>Saccomanni B. <a class=\"external text\" href=\"https:\/\/www.mathewsopenaccess.com\/scholarly-articles\/osteochondral-lesions-of-talus-a-comprehensive-review.pdf\" rel=\"nofollow\">Osteochondral Lesions of Talus: A Comprehensive Review.<\/a> Mathews J Orthop. 2018; 3(1): 021.<\/li>\n<li>Hannon CP, Smyth NA, Murawski CD, Savage-Elliott I, Deyer TW, Calder JD, Kennedy JG. <a class=\"external text\" href=\"https:\/\/online.boneandjoint.org.uk\/doi\/epub\/10.1302\/0301-620X.96B2.31637\" rel=\"nofollow\">Osteochondral lesions of the talus: aspects of current management.<\/a> Bone Joint J. 2014 Feb;96-B(2):164-71.<\/li>\n<li class=\"mw-empty-elt\">\n<\/li>\n<\/ol>\n<h2><span id=\"References\" class=\"mw-headline\">R\u00e9f\u00e9rences<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: References\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;veaction=edit&amp;section=23\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: References\" href=\"\/index.php?title=Management_of_Ankle_Osteochondral_Lesions&amp;action=edit&amp;section=23\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<div class=\"mw-references-wrap mw-references-columns\">\n<ol class=\"references\">\n<li id=\"cite_note-:3-1\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:3_1-0\">1.0<\/a><\/sup> <sup><a href=\"#cite_ref-:3_1-1\">1.1<\/a><\/sup> <sup><a href=\"#cite_ref-:3_1-2\">1.2<\/a><\/sup> <sup><a href=\"#cite_ref-:3_1-3\">1.3<\/a><\/sup> <sup><a href=\"#cite_ref-:3_1-4\">1.4<\/a><\/sup> <sup><a href=\"#cite_ref-:3_1-5\">1.5<\/a><\/sup> <sup><a href=\"#cite_ref-:3_1-6\">1.6<\/a><\/sup> <sup><a href=\"#cite_ref-:3_1-7\">1.7<\/a><\/sup><\/span> <span class=\"reference-text\">Armiento AR, Alini M, Stoddart MJ. <a class=\"external text\" href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0169409X18303193?via%3Dihub\" rel=\"nofollow\">Articular fibrocartilage &#8211; Why does hyaline cartilage fail to repair?<\/a> Adv Drug Deliv Rev. 2019 Jun;146:289-305.<\/span><\/li>\n<li id=\"cite_note-2\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-2\">\u2191<\/a><\/span> <span class=\"reference-text\">Lakin BA, Snyder BD, Grinstaff MW. <a class=\"external text\" href=\"https:\/\/www.annualreviews.org\/doi\/full\/10.1146\/annurev-bioeng-071516-044525\" rel=\"nofollow\">Assessing cartilage biomechanical properties: techniques for evaluating the functional performance of cartilage in health and disease. Annual review of biomedical engineering<\/a>. 2017 Jun 21;19:27-55.<\/span><\/li>\n<li id=\"cite_note-3\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-3\">\u2191<\/a><\/span> <span class=\"reference-text\">Li G, Yin J, Gao J, Cheng TS, Pavlos NJ, Zhang C, et al. <a class=\"external text\" href=\"https:\/\/link.springer.com\/article\/10.1186\/ar4405\" rel=\"nofollow\">Subchondral bone in osteoarthritis: insight into risk factors and microstructural changes<\/a>. Arthritis Res Ther. 2013;15(6):223. <\/span><\/li>\n<li id=\"cite_note-4\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-4\">\u2191<\/a><\/span> <span class=\"reference-text\">Hu Y, Chen X, Wang S, Jing Y, Su J. <a class=\"external text\" href=\"https:\/\/www.nature.com\/articles\/s41413-021-00147-z.pdf\" rel=\"nofollow\">Subchondral bone microenvironment in osteoarthritis and pain<\/a>. Bone research. 2021 Mar 17;9(1):1-3.<\/span><\/li>\n<li id=\"cite_note-5\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-5\">\u2191<\/a><\/span> <span class=\"reference-text\">Imhof H, Sulzbacher I, Grampp S, Czerny C, Youssefzadeh S, Kainberger F. Subchondral bone and cartilage disease: a rediscovered functional unit. Investigative radiology. 2000 Oct 1;35(10):581-8.<\/span><\/li>\n<li id=\"cite_note-:4-6\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:4_6-0\">6.0<\/a><\/sup> <sup><a href=\"#cite_ref-:4_6-1\">6.1<\/a><\/sup><\/span> <span class=\"reference-text\">Lydon H, Getgood A, Henson FMD. <a class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6376560\/\" rel=\"nofollow\">Healing of Osteochondral Defects via Endochondral Ossification in an Ovine Model<\/a>. Cartilage. 2019 Jan;10(1):94-101.<\/span><\/li>\n<li id=\"cite_note-7\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-7\">\u2191<\/a><\/span> <span class=\"reference-text\">Shapiro F, Koide S, Glimcher MJ. Cell origin and differentiation in the repair of full-thickness defects of articular cartilage. J Bone Joint Surg Am. 1993 Apr;75(4):532-53. <\/span><\/li>\n<li id=\"cite_note-:5-8\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:5_8-0\">8.00<\/a><\/sup> <sup><a href=\"#cite_ref-:5_8-1\">8.01<\/a><\/sup> <sup><a href=\"#cite_ref-:5_8-2\">8.02<\/a><\/sup> <sup><a href=\"#cite_ref-:5_8-3\">8.03<\/a><\/sup> <sup><a href=\"#cite_ref-:5_8-4\">8.04<\/a><\/sup> <sup><a href=\"#cite_ref-:5_8-5\">8.05<\/a><\/sup> <sup><a href=\"#cite_ref-:5_8-6\">8.06<\/a><\/sup> <sup><a href=\"#cite_ref-:5_8-7\">8.07<\/a><\/sup> <sup><a href=\"#cite_ref-:5_8-8\">8.08<\/a><\/sup> <sup><a href=\"#cite_ref-:5_8-9\">8.09<\/a><\/sup> <sup><a href=\"#cite_ref-:5_8-10\">8.10<\/a><\/sup><\/span> <span class=\"reference-text\">Krause F, Anwander H. <a class=\"external text\" href=\"https:\/\/eor.bioscientifica.com\/view\/journals\/eor\/7\/6\/EOR-22-0024.xml\" rel=\"nofollow\">Osteochondral lesion of the talus: still a problem?<\/a>. EFORT open reviews. 2022 Jun 1;7(6):337-43.<\/span><\/li>\n<li id=\"cite_note-:0-9\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:0_9-0\">9.0<\/a><\/sup> <sup><a href=\"#cite_ref-:0_9-1\">9.1<\/a><\/sup> <sup><a href=\"#cite_ref-:0_9-2\">9.2<\/a><\/sup> <sup><a href=\"#cite_ref-:0_9-3\">9.3<\/a><\/sup><\/span> <span class=\"reference-text\">Mosca M, Grassi A, Caravelli S. Osteochondral Lesions of Ankle and Knee. Will Future Treatments Really Be Represented by Custom-Made Metal Implants?. Journal of Clinical Medicine. 2022 Jul 1;11(13):3817.<\/span><\/li>\n<li id=\"cite_note-10\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-10\">\u2191<\/a><\/span> <span class=\"reference-text\">Ferkel RD, Chams RN. Chronic lateral instability: arthroscopic findings and long-term results. Foot Ankle Int. 2007 Jan;28(1):24-31.<\/span><\/li>\n<li id=\"cite_note-:6-11\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:6_11-0\">11.0<\/a><\/sup> <sup><a href=\"#cite_ref-:6_11-1\">11.1<\/a><\/sup> <sup><a href=\"#cite_ref-:6_11-2\">11.2<\/a><\/sup> <sup><a href=\"#cite_ref-:6_11-3\">11.3<\/a><\/sup> <sup><a href=\"#cite_ref-:6_11-4\">11.4<\/a><\/sup> <sup><a href=\"#cite_ref-:6_11-5\">11.5<\/a><\/sup> <sup><a href=\"#cite_ref-:6_11-6\">11.6<\/a><\/sup> <sup><a href=\"#cite_ref-:6_11-7\">11.7<\/a><\/sup> <sup><a href=\"#cite_ref-:6_11-8\">11.8<\/a><\/sup> <sup><a href=\"#cite_ref-:6_11-9\">11.9<\/a><\/sup><\/span> <span class=\"reference-text\">Simpson H. Osteochondral Lesions Course. Plus2022<\/span><\/li>\n<li id=\"cite_note-12\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-12\">\u2191<\/a><\/span> <span class=\"reference-text\">Berndt AL, Harty M. Transchondral fractures (osteochondritis dissecans) of the talus. J Bone Joint Surg Am. 1959 Sep;41-A:988-1020.<\/span><\/li>\n<li id=\"cite_note-:1-13\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:1_13-0\">13.0<\/a><\/sup> <sup><a href=\"#cite_ref-:1_13-1\">13.1<\/a><\/sup> <sup><a href=\"#cite_ref-:1_13-2\">13.2<\/a><\/sup><\/span> <span class=\"reference-text\">Badekas T, Takvorian M, Souras N. <a class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3764304\/\" rel=\"nofollow\">Treatment principles for osteochondral lesions in foot and ankle<\/a>. Int Orthop. 2013 Sep;37(9):1697-706. <\/span><\/li>\n<li id=\"cite_note-14\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-14\">\u2191<\/a><\/span> <span class=\"reference-text\">Loomer R, Fisher C, Lloyd-Smith R, Sisler J, Cooney T. Osteochondral lesions of the talus. Am J Sports Med. 1993 Jan-Feb;21(1):13-9. <\/span><\/li>\n<li id=\"cite_note-15\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-15\">\u2191<\/a><\/span> <span class=\"reference-text\">Ferkel RD, Sgaglione NA, DelPizzo W. Arthroscopic treatment of osteochondral lesions of the talus: long-term results. Orthop Trans. 1990;14:172\u2013173.<\/span><\/li>\n<li id=\"cite_note-:2-16\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:2_16-0\">16.0<\/a><\/sup> <sup><a href=\"#cite_ref-:2_16-1\">16.1<\/a><\/sup><\/span> <span class=\"reference-text\">Elghawy AA, Sesin C, Rosselli M. <a class=\"external text\" href=\"https:\/\/bmjopensem.bmj.com\/content\/4\/1\/e000318\" rel=\"nofollow\">Osteochondral defects of the talus with a focus on platelet-rich plasma as a potential treatment option: a review.<\/a> BMJ Open Sport Exerc Med. 2018 Feb 1;4(1):e000318.<\/span> <\/li>\n<li id=\"cite_note-17\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-17\">\u2191<\/a><\/span> <span class=\"reference-text\">Hepple S, Winson IG, Glew D. Osteochondral lesions of the talus: a revised classification. Foot Ankle Int. 1999 Dec;20(12):789-93.<\/span><\/li>\n<li id=\"cite_note-18\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-18\">\u2191<\/a><\/span> <span class=\"reference-text\">Sophia Fox AJ, Bedi A, Rodeo SA. <a class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3445147\/\" rel=\"nofollow\">The basic science of articular cartilage: structure, composition, and function. Sports Health<\/a>. 2009 Nov;1(6):461-8. <\/span><\/li>\n<\/ol>\n<\/div>\n<p><!-- NewPP limit report Cached time: 20230109192436 Cache expiry: 0 Dynamic content: true Complications: () CPU time usage: 0.144 seconds Real time usage: 0.153 seconds Preprocessor visited node count: 522\/1000000 Post\u2010expand include size: 67\/2097152 bytes Template argument size: 0\/2097152 bytes Highest expansion depth: 3\/40 Expensive parser function count: 0\/100 Unstrip recursion depth: 0\/20 Unstrip post\u2010expand size: 16008\/5000000 bytes --><br \/>\n<!-- Transclusion expansion time report (%,ms,calls,template) 100.00% 13.471 1 Special:Contributors\/Management_of_Ankle_Osteochondral_Lesions 100.00% 13.471 1 -total --><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>\u00c9diteur original &#8211; Ewa Jaraczewska d&rsquo;apr\u00e8s le cours de Helene Simpson Principaux contributeurs &#8211; Ewa Jaraczewska, Jess Bell, Lucinda hampton et Kim Jackson Contenu 1 D\u00e9finitions 2 La gu\u00e9rison des l\u00e9sions ost\u00e9ochondrales 2.1 \u00c9tiologie des l\u00e9sions ost\u00e9ochondrales 3 Les l\u00e9sions ost\u00e9ochondrales \u00e0 la cheville 3.1 Syst\u00e8me de classification des l\u00e9sions ost\u00e9ochondrales au niveau du talon [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-4549","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages\/4549","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/comments?post=4549"}],"version-history":[{"count":4,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages\/4549\/revisions"}],"predecessor-version":[{"id":4693,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages\/4549\/revisions\/4693"}],"wp:attachment":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/media?parent=4549"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}