Osteochondral Injury

Ankle locking: osteochondral injury

What is an osteochondral injury

An osteochondral lesion of the talar dome is a combination of the bone (osteo) and cartilage (chondral) surrounding it. The talar dome itself is the cartilage that covers the talus, or the rotating bone of your ankle joint. So an osteochondral lesion of the talar dome is an injury to the cartilage in your ankle joint. Injuries to the bone and overlying cartilage can include fractures, tearing or crushing, and even cysts in the cartilage.

Causes

These type of injuries are most often caused by moderate to intense trauma to the ankle joint, such as with high grade ankle sprains or with repetitive low grade sprains. There are cases in which without an ankle injury and could be caused by local blood flow conditions.

Symptoms 

The symptoms we look for are: Localized pain of the ankle joint, Tenderness and swelling of the ankle joint that is not resolving, Difficulty in weight-bearing.
Patients often have the feeling of locking/catching of the ankle joint, and freezing of movement. This can be due to a loose fragment within the ankle joint.

Diagnosis

Osteochondral injuries are diagnosed by a physical examination, and X-ray and CT and MRI scans. Out of all the imaging modalities, often MRI is the best imaging we will order to diagnosis the condition.

Treatment

Nonsurgical or surgical treatment may be recommended for the management of osteochondral injuries of the ankle joint.

Nonsurgical treatment – Often work with younger population or lower grade injuries

  • Immobilization
  • Restricted to possible non weight-bearing of the affected limb
  • physical therapy
Surgical treatment is recommended for higher grade OCD injuries and to be treated by a well trained and specialized physician.
  • Arthroscopic debridement (removal) of the damaged cartilage and loose bodies.
  • Grafting of cartilage and bone
  • Fixation of the fragments with the help of screws
If you are having any of these ankle symptoms, schedule and appointment to discuss with one of our foot and ankle physicians and surgeons.

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