Osteochondral lesions or osteochondritis dessicans involves injuries to the talus and overlying cartilage. It is often described as fracture the talar cartilage. Talus is the bottom bone of the ankle joint. Much of this bone is covered with cartilage. Talus along with tibia and fibula make up an ankle joint. The blood supply to talus is poor compared to other bones and therefore injuries to talus are more difficult to heal.
Etiology of osteochondral lesions has been debated but trauma (such as ankle sprain) is implicated in many cases as the causative agent. Common symptoms include prolonged pain, swelling, instability of ankle joint. Pain may be felt primarily at the lateral or medial side of the ankle joint. Constant pain despite of appropriate treatment after several months may raise a concern of Osteochondral lesion. Osteochondral lesions are diagnosed using X-rays, MRI, CT scan, bone scan etc. Large lesions are evident on X-rays but other imaging may be necessary to pick up smaller lesions.
Once diagnosed, treatment may consist of non-operative or operative options. Nonoperative treatment involves immobilization, physical therapy, platelet rich plasma injections etc. If nonoperative treatment fails, surgery is recommended. The goals of surgery are to restore normal shape and function of talus and limit risk of developing arthritis. Treatments may include debridement (removing injured cartilage and bone), fixation of the injured fragment, micro-fracture or drilling of the lesion, and/or transfer or grafting of bone and cartilage. If you are experiencing any ankle pain, do not delay treatment. Call our foot and ankle surgeon at 732-297-9535
