Osteochondritis dessicans or osteochondral defect (OCD) is a lesion injury of the talus bone in which the overlying cartilage is damage. There is also increase microtrauma to the talus leading to an increase risk of arthritis in the ankle. The lack of vasculature in the cartilage further separates the cartilage and subchondral bone from the rest of the talar bone and can create a worsening condition called avascular necrosis (AVN). Ankle motion at the site of injury displaces the cartilage and subchondral bone forming a fibrous tissue over the talus and also contributes avascular necrosis of the talus. The cause of the osteochondral defect often is a result of ankle sprain or impact trauma to the ankle joint.
The following are various common treatments that may be considered by your doctor or podiatrist for an osteochondral defect:
- Conservative – rest, ice, NSAIDS, immobilization, etc.
- Physical therapy
- Ankle arthroscopy
- Excision and curettage – excising the damage cartilage and creating micro fracture to be replaced with new fibrocartilage
- Osteochondral Autograft Transplant System (OATS) – transfer of hyaline cartilage to the site of injury
These treatments generally depend on the severity of the talar osteochondral lesion. Less severe cases would only require conservative treatments with immobilization to allow the cartilage and subchrondral bone to heal. Radiographs may not be sufficient to an osteochondral defect and often times additional imaging is needed such as an MRI or a CT scan that can also help determine the severity of the osteochondral defect. Surgical options are very common to treat an osteochondral defect and often have good outcomes. If you have had a history of ankle trauma with persistent pain for at least the past 8 weeks, call your podiatrist as soon as possible to properly diagnosis and address your concerns of an osteochondral defect.
Please visit our website for more information or call 614-885-3338 (FEET) to schedule an appointment with us at our Columbus or Gahanna office