The ankle joints are comprised of the articulation of the tibia, fibula, and talus. The top of the talus is aptly
named for its shape and called the talas dome. As with all joints, the surfaces are covered with articular
cartilage which is smooth and provides for efficient shock absorption and smooth movement between the
bones. When this cartilage and the underlying bones are damaged, a talar dome lesion or an osteochondral
effect is diagnosed. In many cases, talar dome lesions form following a previous ankle injury. Several other
situations may result in talar dome lesions:

Cause of talar dome lesions:
1. Trauma – Acute injuries such as ankle sprains or fractures can cause damage to the talar dome.
2. Overuse – Repetitive stress or overuse of the ankle joint can lead to wear and tear on the talar dome
resulting in a lesion.
3. Arthritis – Inflammation and degeneration of the ankle joint can lead to damage to the talar dome.
4. Osteochondral lesions: A lesion or defect in the cartilage and bone of the talar dome itself.
5. Osteonecrosis – In osteonecrosis, the blood supply to the bone is interrupted which leads to the death
of the bone tissue in the talar dome.
6. Congenital defects – Some people may be born with a malformed talar dome which makes it more
susceptible to injury.

It’s important to remember that because talar dome lesions can be caused by multiple factors, an accurate
diagnosis is necessary to determine the underlying cause, which will then provide for the development of an
appropriate treatment plan.

Symptoms of talar dome injury:
Pain and swelling are the first symptoms expressed by patients suffering from a talar dome injury. They also
report difficulty in bearing weight on the affected foot and sometimes experience difficulty moving the foot or
ankle. In some cases, there may also be a visible deformity or they heard a popping sound when the injury
occurred. If you suspect that you have injured your talar dome, you should schedule an appointment with a foot
and ankle specialist for an evaluation. North Texas Foot and Ankle will provide you with a comprehensive
examination which will include a physical exam with a range of motion testing, and possibly be followed by an
X-ray, MRI, or CT scan to confirm the diagnosis and determine the size and location of the lesion.

Manage talar dome lesions:
Treatment for a talar dome lesion will depend on the specific type of injury and its severity. In some cases,
non-surgical treatment is the best option, and resting physical therapy, and the use of a brace or case may be
sufficient. In more severe cases, surgery may be necessary. Surgical intervention will include debridement,
removal of damaged tissue, and repair to or reconstruction of the talar dome. Regardless of the treatment
option, it’s super important to participate in a rehabilitation regime to regain function of the ankle and prevent it
from happening again. Strength training, range of motion exercises, and balance training may all be a part of
post-treatment/post-surgical rehab.

Injury to the ankle is always a reason for concern. Don’t leave recovery to chance. A proper diagnosis and
corresponding treatment plan are important to fully regaining your ability to walk. Click here to schedule an appointment or call us at 214-574-9255. North Texas Foot and Ankle, relieving the pain and getting you back
on your feet.