Cartilage degeneration in talocrural and talocalcaneal joints from Japanese cadaveric donors

In a study human cadavers, degenerative change (DC) was observed more frequently on articular surfaces of the talocrural joint (55. 8%) than on the articular surfaces of the talocalcaneal joint (29. 5%). In the talocrural joint, the anteromedial segments of the tibial plafond, talar dome, and the medial malleolar facet exhibited a high frequency of DC. Moreover, most DCs were found to coexist in multiple segments that often included both the tibial and talar sides. In the talocalcaneal joint, by contrast, DC tended to be distributed diffusely over the articular surfaces. If the DC occurred initially and progressed to a cartilage defect, it tended to be restricted to a certain portion of the talocalcaneal joint. Mirror-image lesions were observed much less frequently than expected in both the talocrural (28.3%) and talocalcaneal joint (25. 0%). Notably, these lesions were not usually observed even if the DC had progressed to a cartilage defect. We considered that the DC tended to advance to the adjacent segment on the same side rather than to the complementary segment on the opposite side. We demonstrated that the more multiple DC lesions were present in the talocrural joint, the more often DC occurred in the talocalcaneal joint. Consequently, we believe than multiplicity of DCs is more critical for the downward joint-to-joint progression of DC than is increased severity.