Items filtered by date: November 2017

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

Haglund’s deformity, often called pump bump, is a painful bony prominence and bursitis located on the lateral posterior superior aspect of the calcaneus bone above the Achilles tendon insertion. This condition also leads to a retrocalcaneal bursitis in which a painful bursa develops in between the Achilles and superior posterior calcaneus. With a bony prominence, there is a constant and chronic irritation of the pump bump and the back of shoes. Your doctor or podiatrist will order radiographs with lateral views of the foot to confirm a positive diagnosis of a Halgund’s deformity.

The following are conservative treatments that may be considered by your doctor or podiatrist for a painful Haglund’s deformity:

• Shoe modifications – open back shoes or open heels
• Orthotics and heel lifts
• Rocker sole shoes
• NSAIDS
• Steroid injection
• Aspiration of the bursa
• Topical anti-inflammatory and capsaicin cream

If the pain does not resolve with conservative treatments, there are various surgical procedural options that your podiatrist may suggest to you. Furthermore, operative treatments are very common in resolving a painful Haglund’s deformity. Some examples include extracorporeal shock wave therapy (ECSWT), Achilles lengthening, removal of the inflamed bursa, and/or resection of the bony prominence. In general, after surgery, you will need to be in a below-the-knee cast and be non-weight bearing for about 3 to 4 weeks. When you are tired of experiencing chronic pain in the back of the heel, call your podiatrist as soon as possible for the best treatment option of a Halgund’s deformity.

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