A 13-year-old male competitive club soccer player with a history of bilateral Osgood-Schlatter disease over the past 6 months reported unusually high fatigue and right heel pain after a match. Over the next 4 days, fever developed and persisted despite antipyretics. Right heel pain, warmth, and redness increased until weight-bearing was not tolerated. Subsequent imaging and blood work eventually lead to a calcaneal osteomyelitis diagnosis. A bone biopsy procedure and a 6-week course of antibiotics were completed. The rehabilitation and conditioning plan, which was successful, was based on assessment findings and targeted a return to sport 12 weeks postsurgery. Interprofessional collaboration was key for the diagnosis and effective medical treatment. Rehabilitation and conditioning protocol development was challenging as (1) no postsurgical rehabilitation protocol for a patient with calcaneal osteomyelitis wishing to return to sport has been described and (2) the impact of postinjury rehabilitation on training load is poorly documented.

Osteochondroses of the foot represent a unique and less frequently discussed topic. This narrative review aims to provide a comprehensive overview of foot osteochondroses, highlighting their definition, pathophysiology, clinical features, diagnosis, and treatment. Historical sources, including early case reports, were included along with the current literature to picture the current knowledge on the subject. Anatomical mapping of pain locations and associated ossification centers was employed as a framework to present the various forms of foot osteochondroses. Multiple types of foot osteochondrosis were identified. The calcaneus, navicular and lesser metatarsal are among the more common involved bones. Most forms share a multifactorial etiology involving mechanical stress, vascular insufficiency, and delayed ossification. The pain is localized and common to all forms. Diagnosis relies on clinical assessment supported by radiographic and sometimes magnetic resonance imaging findings. During the acute phase, joint rest is essential. Despite the potential for spontaneous resolution, some cases can lead to structural deformities or persistent symptoms. Foot osteochondroses, although rare, require careful clinical evaluation due to their impact on pediatric patients. Increased awareness and standardized treatment approaches may improve early recognition and management, potentially reducing long-term sequelae.

Köhler's disease is a self-limiting disorder affecting endochondral ossification, marked by fragmentation and sclerosis in the tarsal navicular bone. In 1908, Köhler highlighted these complexities by describing concurrent osteochondrosis of the tarsal navicular. A relevant case involves a 5-year-old girl who visited an orthopedic clinic with bilateral foot pain and an inability to bear weight for a week. She was diagnosed with bilateral Köhler's disease. Although uncommon, Köhler's disease should be considered in the differential diagnosis of pediatric foot pain to avoid unnecessary treatments and to ensure optimal care for the patients.

Osteochondritis dissecans (OCD) and osteochondrosis (OC) are multifactorial developmental joint diseases that can occur in various anatomical locations, including the tarsus of immature, rapidly growing large breed dogs. The pathogenesis of canine OCD and OC involves a disruption in endochondral ossification, resulting in a failure of matrix calcification and vascular invasion. This study aimed to investigate the subchondral bone density changes in Labrador Retrievers with tarsocrural OCD/ OC. A total of 8 dogs with unilateral tarsocrural OCD/ OC were included in the study and density was evaluated with Computed Tomography osteoabsorptiometry (CTOAM ). The findings revealed a significant decrease in subchondral bone density at the location of the OCD/ OC lesion, particularly at the medial trochlear ridge. This area of low density was surrounded by a higher density rim. Furthermore, the contralateral joint showed a significantly higher overall mineral density. These results highlight the significant changes in bone mineral density associated with tarsocrural OCD/ OC. The lower density in the affected joint suggests pathological alterations in the subchondral bone, which may impact the bone turnover and contribute to the development of secondary osteoarthrosis, subsequently. The higher density observed in the contralateral joint emphasizes the role of altered joint loading and adaptation in the subchondral bone.

Implantation of minced cartilage is a one-step-procedure that leads to satisfactory results in osteochondral defects. A retrospective review was performed on a consecutive cohort of patients that received minced cartilage with fibrin (MCF), minced cartilage with membrane and fibrin (MCMF) and minced cartilage with the "AutoCart"-procedure (MCAC) between January 2019 and December 2023. Radiological outcome parameters were evaluated via Magnet-Resonance-Tomography (MRI) within one year using Ankle-Osteoarthritis-Scoring-System (AOSS). Final data included 25 patients: 13 women and 12 men with a mean age of 28.2 years ± 10.9(range:18-51). Mean defect size was 103.6mm2 ± 59.0(95% CI = 79.2-128.0), mean depth 5.2 mm ± 3.6(3.7-6.6). Differences between groups in defect sizes were not significant (p = 0.999). MCF was carried out in 9(36.0%), MCMF in 7(28.0%) and MCAC in 9(36.0%) patients. Mean postoperative AOSS values were 2.6 ± 1.9(95%CI:1.1-4.1) for MCF-patients, 3.3 ± 2.9(0.6-5.9) for MCMF patients and 3.9 ± 2.8(1.7-6.1) for MCAC-patients, respectively. Differences were not significant (p = 0.639). Revision surgery because of symptomatic non-integration of the graft or ventral impingement occurred in 5(20%) of cases - all part of MCAC-patients that did not receive additional fibrin fixation as the top layer of transplant (p < 0.05). Autologous minced cartilage implantation seems to be sufficient as a viable, one-step treatment for osteochondral lesions of the talus. It leads to low complication rates and excellent AOSS values within a 12-month period whereas the application of fibrin as the last fixation layer seems to be advisory, which demands further investigation.