Epidemiologically, the ankle registers 4% of all the human osteochondral defects. If the cartilage does not heal properly following the injury, it softens and begins to break off. Overall, more than 80% of the talus OCLs are of traumatic origin. If the fragment has come loose, it can also cause locking or instability symptoms. Fig. In many cases of OCD in children, the affected bone and cartilage heal on their own, especially if a child is still growing. Therefore a small anteromedial synovectomy is done using a 5.5 mm bonecutter shaver with the ankle in the dorsiflexed position. Therapeutic arthroscopy with microfracture leads to fibrocartilaginous repair and is an effective treatment of osteochondral lesions of the talus. Manage pain 3. 1 The knee joint is perhaps one of the busiest joints in the body as it bears most of the body weight when standing. However, it can be subdivided into a traumatic and nontraumatic cause. Keywords Osteochondral defect Cartilage Ankle joint Subchondral cyst Natural history Pain Introduction An osteochondral defect (OD) of the talus is a lesion involving the talar articular cartilage and its subchondral bone mostly caused by a single or multiple traumatic events, but idiopathic OD of the ankle do occur [8, 46, 47, 50]. Talar Osteochondral Defects Diagnosis, Planning, Treatment, and Rehabilitation. In acute conditions, symptoms of osteochondral ankle defects are similar to those of acute ankle injuries. With disease progression, the fragment may detach, leading to degenerative osteoarthritis . It may result in a defect that subsequently affects the subchondral bone and, in severe cases, may lead to formation of an osteochondral fragment. “Osteo” means bone and “chondral” refers to cartilage. The ankle is plantarflexed to visualize the osteochondral defect (OCD). Protect surgical ankle 2. Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. An osteochondral lesion of the talus (OLT) is an area of abnormal, damaged cartilage and bone on the top of the talus bone (the lower bone of the ankle joint). INTRODUCTION. The common treatment strategies of symptomatic osteochondral lesions include nonsurgical treatment, with rest, cast immobilisation and use of nonsteroidal anti-inflammatory drugs (NSAIDs). (OBQ12.74) A 21-year-old male reports right ankle pain after sustaining an inversion ankle injury 2 years ago. Clinical Relevance: The location of peak stress in the ankle joint becomes closer to the rim of the defect in OLTs at a threshold of 10 mm and greater in diameter. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). Ankle: Chondral/Osteochondral Defect Repair ... 1. 31. van Dijk CN, Verhagen RA, Tol JL (1997) Arthroscopy for. When two bones move relative to each other, their surface consists of a softer substance that we call cartilage. Osteochondral lesions are injuries to the talus (the bottom bone of the ankle joint) that involve both the bone and the overlying cartilage. Osteochondral defect or Cyst. Immobilization of the ankle, medications, steroid injections and physical therapy are commonly tried but this often fails to relieve symptoms and surgery may be required. 20 The treatment of talar OCDs is usually initiated with a nonoperative protocol. Physicians can upload their anonymized problem case for expert advice. Control post operative pain/swelling Treatment: - Patient to be progressed to PWB (up to 30% body weight) if a small lesion (per MD’s recommendations). Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. Osteochondral lesion (OCL) describes an injury to the articular cartilage surface of bone within a joint. An osteochondral defect (OCD) of the ankle joint can lead to localised pain, swelling and stiffness in the ankle with difficulty weight bearing and mobilising. During his workup, an MRI shows a 1x1 cm lateral talar osteochondral defect (OCD). The broad term “osteochondral lesion of the talus” describes an injury or abnormality of the talar articular cartilage and adjacent bone.1 We can describe lesions as a cartilage defect, bone cyst or subchondral bone cyst. This type of injury can be due to a severe ankle sprain that causes bone and cartilage to become loose, resulting in ongoing ankle pain. Tol et al. 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