osteochondral lesion treatment

One would use a non-invasive ankle distractor to distract the joint and check the lesion. With proper procedure selection, the options for osteochondral lesion treatment are improving and have great outcomes. Non-surgical treatment is appropriate for certain lesions and usually involves immobilization and restricted weightbearing. It is important to pack the lesion fully to avoid further cyst formation. Treatment depends on the severity of the talar dome lesion. Initial x-rays are taken to check the alignment of the foot and ankle, as well as look for any bone damage. An osteochondral lesion is a defect in the cartilage of a joint and the bone underneath. Most of the lesions requiring surgical treatment are posteromedial in location, have poor quality articular cartilage, a loose bone fragment, necrotic bone beneath the lesion, and are poor candidates for healing with internal fixation. INTRODUCTION. Over the next few years, one may be able to begin treating cartilage lesions with cartilage cell transplants through an injection and with cartilage caps. For stable lesions, non-operative management is usually the first step including: Many scans may miss the damage caused by the lesion, which is also masked by the sprain or trauma that caused the injury. Arthroscopic surgery is a procedure that is frequently used as a treatment to remove the loose cartilage and bone tissue from the joint. A patient with an osteochondral lesion will often feel a dull ache in the joint and may also experience a mild locking or clicking of their knee or ankle joint. An osteochondral lesion may also be known as an osteochondral defect. Causes: Talar dome lesions … In some cases a cast must be worn for part or all of that period. 109. Nonoperative treatment for acute, nondisplaced osteochondral lesions of the talus and cystic lesions has been associated with successful clinical results in about 50% of cases 5, 24, 25. It can be challenging to diagnose an osteochondral lesion at the time of injury. This surgery may be performed open or arthroscopically. If the MRI shows a cystic lesion and we are concerned about the overlying cartilage and bone seal, and if there is a small fracture in the overlying subchondral bone region, we will often get a CT scan after the MRI. Cartilage is a connective tissue that covers the bones between joints. With an inversion or eversion stress on the ankle, the talus and tibia and/or fibula will contact each other with a massive stress, resulting in a compression or shear stress on the surface of the talus and underlying injury. Seven studies described the results of non-operative treatment, 4 of excision, 13 of excision and curettage, 18 of excision, curettage and bone marrow stimulation (BMS), 4 of an autogenous bone graft, 2 of transmalleolar drilling (TMD), 9 of osteochondral transplantation (OATS), 4 of autologous chondrocyte … In some cases, both an MRI and CT are needed to diagnose an osteochondral lesion. Choose a doctor and schedule an appointment. For small-sized defects with intact cartilage, our treatment of choice is Retrograde Drilling of the lesion and filling it with a special bone cement. Cedars-Sinai has a range of comprehensive treatment options. Osteochondral lesions of the talus (OLTs) are a difficult pathologic entity to treat. Osteochondritis dissecans (OCD or OD) is a joint disorder primarily of the subchondral bone in which cracks form in the articular cartilage and the underlying subchondral bone. If the fragment is unstable or loose in the joint, surgery may be necessary to remove and repair the injured area. Treatment of Osteochondral Lesions of the Talar Dome James W. Stone MD Key Points Although osteochondral lesions can occur over any portion of the talar dome or the tibia, the talar lesions typically occur over the anterolateral or the posteromedial talar dome. Surgical treatment of talar OLTs includes: Arthroscopic … 1. ➢ Operative treatment should be reserved for patients who have mechanical symptoms following an acute osteochondral lesion of the talus or who are not satisfied with the result after 3 to 6 … Stage 1,2 and 3 lesions are less likely to progress to arthritis and do well with non-operative management. Operative Treatment . Osteochondral lesions of the talus (OLT) are those that affect the chondral and subchondral areas of the talus. Scranton PE and McDermott JE. Treatment. There is also a problem with mild sclerosis of the walls of the cyst that one must treat. This type of injury is fairly rare. Although the cause of such lesions is unknown, they may involve a genetic predisposition to such a condition. What Are The Vascular Ramifications Of COVID-19? For older patients, a knee replacement may be an option. Our preferred technique is to use a 0.62 K-wire and drill lesions in the posterior medial region that cannot be reached with a chondral pic through a medial incision approach. Diagnosing an osteochondral lesion is very difficult on a physical exam and one rarely diagnoses this without further testing. After performing this procedure, one should emphasize non-weightbearing for six to eight weeks and again use a CT scan to check healing. Treat subchondral edema either through a retrograde approach from the sinus tarsi or from an intraarticular approach through the lesion site via subchondroplasty with or without a bone marrow aspirate add-on. There are three types of common lesion formation. The most common surgical procedure for an osteochondral lesion is an arthroscopic exploration and treatment. Often, it is difficult to reduce pain permanently with bracing or casting. There is no cure as such, but the condition can be treated by a variety of means depending on the size and location of the lesion as well as the age of the patient and the degree of symptoms. We will now discuss the final common problem, which involves the treatment options for osteochondral lesions of the talus. Yet a more sedentary patient with the same lesion may do well with drilling. Podiatry Today is a trademark of HMP. Within the ankle, these lesions often occur on the talus, which is the bone that joins the foot and the leg together. Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. The damaged cartilage is cleaned out and removed. There is a great deal of debate as to whether you should use autograft, fresh allograft or graft substitutes. Three Easy Steps For A Simple And Reproducible Lapidus Procedure, When A Patient With A Sesamoid Fracture Develops Uncontrolled Pain And Swelling, Current Insights On The Diagnostic Algorithm For Charcot Neuroarthropathy, Keys To Deltoid Ligament Repair After Ankle Fracture, Protocols for the Prevention and Treatment of Pressure Injuries: Sustaining Outcomes at the Point of Care, Modern Techniques to Manage Infected Wounds in the Diabetic Patient: Integrating Advanced Technologies to Optimize Healing, Examining the Use of Purified Collagen Matrix with Antimicrobial for Treating Chronic Wounds. If the lesion is stable (without loose pieces of cartilage or bone), one or more of the following nonsurgical treatment options may be considered: Immobilization. Treatment of type V osteochondral lesions of the talus with ipsilateral knee osteochondral autografts. Immobilization – Depending on the type of injury, the leg may be placed in a cast or cast boot to protect the talus. We prefer the use of autograft and often harvest the material from either the calcaneus or distal tibia. Informed consent must include the possible need for further surgery, graft failure/nonunion and the potential need for ankle fusion or replacement. The goal of treatment is to ease pain and get your child back to using their joint normally. When the latter is present, then joint replacement is often the only feasible treatment. However, if the osteochondral lesion is identified at an earlier stage, other treatment solutions are feasible. However, in most cases with larger lesions, the surgeon should completely excise the lesion and use osteochondral grafting. Patients may have an OLT that is present a… For related articles, check out the archives at www.podiatrytoday.com. However, if the osteochondral lesion is identified at an earlier stage, other treatment solutions are feasible. The goal of non-surgical treatment is to allow the injured cartilage and bone to heal. If the damage is small, the surgeon may drill into the bone, which causes a small amount of bleeding and encourages healing. Treatment. 108. Osteochondral fracture of the lateral femoral condyle is a rare injury of the knee joint, which mostly occurs in adolescence 1.In adolescence, the cartilage‐bone interface is the weakest transitional area in the knee joint, and there is no obvious boundary between calcified and uncalcified cartilage 2.The biomechanical strength of immature osteochondral junction was lower … The first is injury to the cartilage surface with an actual loss of part of the chondral surface and underlying subchondral bone. Furthermore, the location of the lesion will also dictate treatment options. Remove the lesion and all non-viable articular cartilage. Osteochondral lesions of the talus (OLT) are those that affect the chondral and subchondral areas of the talus. Treatment depends on the severity of the talar dome lesion. Scranton PE, Jr., Frey CC, Feder KS. If an osteochondral lesion has occurred, however, everyday activities that put pressure on the joint, may lead to pain and swelling, although the joint usually is fine when at rest. Physiotherapy is then recommended to rehabilitate the affected knee or ankle. The treatment approach is based on the size, location and degree of separation of the bone and cartilage. Individuals who play sports such as soccer, football, rugby and golf may be at risk of an osteochondral lesion. The affected joint may also seem to be loose. They require a strong plan. Scranton PE, Jr., Frey CC, Feder KS. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. One can use two allograft regions that mimic the normal makeup of talar cartilage. The vast majority of patients experience no pain or swelling even 10 years after surgical treatment of such lesions in the ankle. The size of the lesion … A second point to consider is the level of activity the patient would like to return to. This allows us to treat the bone defect without affecting the cartilage. Microfractures, are often considered the first-line surgical treatment option due to the low costs and ease of the technique (34-38), while ACI is rather reserved as a salvage procedure (39-41, 45). In general, our guideline for a cutoff for drilling options is a lesion less than 1 cm in diameter and a lesion less than 0.5 cm in depth. Within the ankle, these lesions … For example, an elite athlete with a large cystic lesion will not do well with drilling of the lesion and may require a grafting of the site. Outcome of osteochondral autograft transplantation for type-V cystic osteochondral lesions … this is sutured … An osteochondral defect refers to a focal area of damage that involves both the cartilage and a piece of underlying bone. Although the treatment of osteochondral lesions of the talus has evolved and improved, there is a need to understand the full spectrum of treatments and be well-versed in all forms of treatment in order to have a complete bag of tools necessary to treat these complicated occurrences. Treatment options include: non-operative conservative therapy (including but not limited to modification of activity, injections, casting, or boots), various surgeries like “microfracturing” the affected bone which brings new cells to the area in hopes building new cartilage, or transplantation of cartilage/bone from a donor or different body part. With medial lesions, one must osteotomize the medial malleolus to access the joint. A Stable lesion means that the cartilage overlying the bone is not damaged and the lesion is not likely to be lose. How To Diagnose And Treat Osteochondral Lesions Of The Talus, How To Assess And Treat Ligamentous Laxity Syndromes In The Foot And Ankle, Pertinent Pearls In Evaluating And Treating Chronic Ankle Instability, Current Best Practices In The Treatment Of Plantar Plate Tears. If the patient presents such kind of changes, the most recommended form of intervention is represented by the complete replacement of the joint. Although wearing a brace or cast may ease the discomfort of an osteochondral lesion, they are usually not enough to remedy the problem permanently, except in children, who can respond well to non-surgical treatment. In cases of osteochondral lesion, the patient will begin to experience swelling and pain in the ankle with this increased activity. In order to treat the problem properly, one must diagnose the cause, the amount of injury and the residual problem present. Treatment of the subchondral bone will aid in pain relief even if one treats the overlying cartilage. periosteum from tibia taken and fitted to defect. Often, performing an injection of local anesthetic into the involved joint will reduce pain but clinicians should not rule out other problems such as loose bodies, synovitis and ligament injury. This may be followed with gradual progression of weightbearing and physical therapy. Osteochondral Defect is the name given to a condition most noticeable in the knee, in which a part of the bone and cartilage gets separated from the knee joint. The diagnosis of cartilage damage (osteochondral lesion, also known as talar dome) is often done with x-rays and/or an MRI. “Osteo” means bone and “chondral” refers to cartilage. These can occur from an acute traumatic injury to the knee or an underlying disorder of the bone. All Rights Reserved. Cast immobilization: If the OLT occurs following an acute injury, initial immobilization in a cast for 4 … The common treatment strategies of symptomatic osteochondral lesions include nonsurgical treatment, with rest, cast immobilisation and use of nonsteroidal anti-inflammatory drugs (NSAIDs). Repetitive trauma has also been associated with the development of such lesions. The most common location of osteochondral lesions … After removing all non-viable cartilage, the surgeon should fenestrate the subchondral bone with either a K-wire or a chondral pick. An X-ray may be ordered, but a cartilage tear is difficult to see on an X-ray, so a magnetic resonance imaging (MRI) or computed tomography (CT) scan may be required. The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. INTRODUCTION. Often, the problem is not diagnosed at the initial time of injury either because clinicians did not obtain radiographs or the radiographs do not show a clear lesion. Osteochondritis dissecans (OCD) is a condition that develops in joints, most often in children and adolescents. Clean out the lesion with a small curette and debride the sclerotic walls. OCD usually causes pain … This type of treatment is best in large lesions with a major defect of over 1 cm with extensive depth. We have dealt with the actual ligament injury and its repair, treatment of peroneal tendon injuries and also conservative care of ankle injuries. 108. 109. The newest and most complicated treatment option is the use of retrograde drilling of the lesion. This chapter is adapted from Chao W, Freeland E, Dedini R: Osteochondral Lesions … The treatment of an osteochondral lesion is based on the stability of the lesion. This is referred to as an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). Treatment depends upon the size of the osteochondral defect and the condition of the overlying cartilage. It is at this point that the patient will present for further consultation. © 2020 HMP. They also may be caused by abnormal bone development, especially when they occur in children. It is not a preferred option for younger patients, since failure of the knee replacement and the need for revision is more likely in younger patients. After the initial pain and discomfort of a strain or sprain subsides, individuals usually resume or even increase their activity level. The best option is a fresh allograft talus. Conservative care of osteochondral lesions is difficult. It occurs when a small segment of bone begins to crack and separate from its surrounding region due to a lack of blood supply. In this type of lesion, the pain is from the constant compression of the cyst with activity but there is no overlying damage to the cartilage and bone. Have the patient emphasize non-weightbearing for a period of four to six weeks and immediately start using a passive range of motion machine. Continued. Most commonly, a surgeon will perform an arthroscopic exploration and treatment. Surgical treatment is indicated for displaced talar OLTs or lesions that have not improved with appropriate non-operative management. A 501(c)(3) non-profit organization, Osteochondral Lesions/Osteochondritis Dessicans, Translation is unavailable for Internet Explorer. The treatment for Osteochondral Defect depends on the size of the defect and whether the overlying cartilage is damaged. For most kids and young teens with osteochondritis dissecans, the … - Operative Treatment: - Arthroscopy of the Ankle: - osteochondral lesions of the talus can be debrided, and loose bodies and small osteochondral fragments can be removed; - use of non-invasive or invasive distraction improves access to joint and allows adequate debridement and curettage of bed; Platelet-rich plasma is significantly better than hyaluronic acid. The size of the lesion … The prevailing thinking is that magnetic resonance imaging (MRI) is better in cases of pure cartilage damage or for superficial lesions while computerized tomography (CT) is better for cystic lesions and lesions that involve both cartilage and bone injury. Pertinent Pearls For Performing An Arthroscopy. Pain often occurs with an increase in activities such as sports and is not present with rest. If radiographs show an osteochondral injury at the initial visit for an ankle sprain, treatment will require either casting of the ankle to allow the fracture site to heal or pinning and open reduction of the fracture in cases of a loose lesion. An osteochondral lesion may also be known as an osteochondral defect. OCD usually causes pain during and after sports. Nonsurgical Treatment Approaches. Operative treatment might also be necessary if patients do not respond well to conservative treatment. As the size of the lesion and, more importantly, the depth of the lesion increase, drilling and removal of the lesion show less than perfect outcomes. Treatment depends on the severity of the talar dome lesion. After surgery, weight should be kept off the affected knee or ankle for four to six weeks. Then you fill the region with either allograft or autograft. Finally, there is a subchondral cyst type injury with a cyst formation deep to the cartilage surface but an intact overlying cartilage and bone surface. Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management.. stage I. injury limited to articular cartilage; … This is easy to identify since the region of damaged cartilage will feel soft and a probe will easily penetrate the cartilage during arthroscopic examination. Know what is Osteochondral defect, its causes, symptoms, treatment and prevention. In the ankle, osteochondral lesions usually occur on the talus, which is the bone that connects the leg to the foot. Surgical options differ according to the size, depth and amount of damage associated with an osteochondral lesion. Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. Patients will note a dull ache of the joint and may also describe mild to moderate locking or clicking. Surgical options differ according to the size, depth … One may use radiographs to check for a cyst formation or cartilage damage but this imaging rarely shows definitive involvement. This is referred to as an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). For small sized defects if the overlying cartilage is intact, then … Operative Treatment . It is important to understand the principles of arthroscopy and the use of a microvector guide in the treatment of osteochondral lesions. [] This is a broad terminology that encompasses a variety of disorders including osteochondritis dissecans, osteochondral fractures, and osteochondral … There is a great deal of debate as to which adjunct testing is best for diagnosing an osteochondral lesion. The second most common type is an injury to the superficial cartilage surface with a crush cartilage injury or shear tear of the cartilage surface. Osteochondritis dissecans (OCD) is a condition that develops in joints, most often in children and adolescents. I hope the information presented is helpful for your patient care. With an MRI, the ligament structures, tendons and cartilage of the ankle can be examined and analyzed. With an MRI, the ligament structures, tendons and cartilage of the ankle can be examined and analyzed. Usually, an osteochondral lesion occurs when there is an injury to the joint, especially if there is an ankle sprain or if the knee is badly twisted. the lateral osteochondral defect. Peroneal Tendon Dysfunction: Why Peroneal Tendon Tears Should Be Treated Like Posterior Tibial Tendon Tears. We will often try a period of casting for osteochondral lesions with a small fracture fragment but have found poor outcomes with healing in such cases with conservative care. For adults, such a condition usually requires surgery. These can occur from an acute traumatic injury to the knee or an underlying disorder of the bone. Typical modalities of activity modification, bracing, nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, and protected weight-bearing in a walking boot may alleviate symptoms 26 - 28 . Osteochondral Lesions of the Talus Sara Lyn Miniaci-Coxhead, MD Dr. Miniaci-Coxhead or an immediate family member serves as a board member, owner, officer, or committee member of the American Orthopaedic Foot and Ankle Society. At earlier stages (stage 1 to 4), a number of options exist including: osteochondral … What Bunion Procedures Does A Surgeon Need To Master? A chondral defect refers to a focal area of damage to the articular cartilage (the cartilage that lines the end of the bones). Surgical treatment of OCLs traditionally includes excision of loose bodies, debridement of the area, and drilling or microfracturing. If the patient presents such kind of changes, the most recommended form of intervention is represented by the complete replacement of the joint. The treatment approach of the osteochondral lesion is influenced by a number of factors, such as: location and size of the lesion, presence of secondary degenerative changes. Osteochondral lesions of the talus occur for several reasons. Nonsurgical Treatment Approaches. debridement of lesion to create stable cartilage rim, subchondral bone exposed. Actual surgical treatments for osteochondral lesions and early knee osteoarthritis seem to be promising. Within the knee, cartilage damage can happen between the thigh bone and the shinbone. Osteochondral defects generally linger or get worse unless they’re treated. Conservative treatment of osteochondral lesions of the talus (OLTs) should be attempted first, whenever possible. The most common location of osteochondral lesions in patients with ankle trauma is on the anterolateral or pos- Use the OATS system to remove the plug of damaged cartilage and bone to a depth of 1 cm or so, and utilize a replacement graft. The diagnosis of cartilage damage (osteochondral lesion, also known as talar dome) is often done with x-rays and/or an MRI. In certain cases, an OATS allograft option is the best option. A talar osteochondral lesion (OLT) can develop after ankle sprains or ankle trauma. A medial lesion was reproduced by plantarflexing the ankle in combination with slight anterior displacement of the talus on the tibia, inversion, and internal rotation of the talus on the tibia. A period of … In order to protect the soft tissues, one should drill through the medial malleolus with the use of a microvector guide. I would recommend starting with the treatment of easy lesions prior to trying the complex and large lesions. The past several “Treatment Dilemmas” columns have dealt with the treatment of chronic ankle pain subsequent to an ankle sprain (see page 92, July issue and page 88, September issue). All Rights Reserved. An osteochondral lesion is an injury or small fracture of the cartilage surface of the talus. When there is a break, tear, separation, or disruption of the cartilage that could be referred to as an osteochondral lesion… Although wearing a brace or cast may ease the discomfort of an osteochondral lesion, they are usually not enough to remedy the problem permanently, except in children, who can respond well … In the knee, such cartilage damage can occur between the femur (thigh bone) and the tibia (shin bone). If the fragment is unstable or loose in the joint, surgery may be necessary to remove and repair the injured area. Dr. Baravarian may be reached at bbaravarian @mednet.ucla.edu. Treatment depends on the location and size of the defect as well as the presence of secondary degenerative changes. An OLT is an injury to the cartilage and underlying bone of the talus within the joint, where it begins to soften and break off as a result of not healing properly. An osteochondral defect refers to a focal area of damage that involves both the cartilage and a piece of underlying bone. Once the diagnosis has been confirmed, treatment may be surgical or non-surgical, depending on the nature of the OLT, presence of other injuries and patient characteristics. Each type of injury will have different treatment options and require a different type of workup. A medial lesion was reproduced by plantarflexing the ankle in combination with slight anterior displacement of the talus on the tibia, inversion, and internal rotation of the talus on the tibia. This is very simple to perform and one would make several drill holes into the lesion to allow for bleeding and fibrocartilage formation. Non-operative treatment can be successful for non-displaced talar OLTs, especially if the condition is recognized and treated early, and the lesion is relatively small. Foot and Ankle International, May 2001; 22(5): 380-384. We have found equally good outcomes with the use of autograft and fresh allograft, and therefore use the fresh allograft as our primary option. Treatments for lesions in the knee are more challenging, but also have promising outcomes. By Jeffrey E. McAlister, DPM, FACFAS, and Eric So, DPM, AACFAS |. One should physically examine the ankle to check for instability and tendon or ligament injury. Use a cast to allow for healing of the lesion for six to eight weeks. Osteochondritis dissecans (OCD or OD) is a joint disorder primarily of the subchondral bone in which cracks form in the articular cartilage and the underlying subchondral bone. Dr. Baravarian is the Co-Director of the Foot and Ankle Institute of Santa Monica. Lesions can be stable or unstable. If a lesion is a corner lesion involving both the dorsum and lateral wall of the talus, remove the entire lesion with a saw and use a square block to replace the defect. Lesion size, location, chronicity, and characteristics such as displacement and the presence of subchondral cysts help dictate the appropriate treatment … Treatment and prognosis. this is sutured into place this small caliber suture, omitting one area to leave access to underlying defect. Outcome of osteochondral autograft transplantation for type-V cystic osteochondral lesions of the talus. This is the most common type of injury that will require care. An osteochondral defect can occur acutely or develop as a result of several chronic conditions including (a) separation of the osteochondral fragment caused by an acute traumatic injury or as the end result of an unstable fragment in osteochondritis dissecans (OCD), (b) acute osteochondral … One would perform an arthroscopy of the joint and identify the lesion. Within the knee, cartilage damage can happen between the thigh bone and the shinbone. If the lesion is stable (without loose pieces of cartilage or bone), one or more of the following nonsurgical … Medial lesions … The common treatment strategies of symptomatic osteochondral lesions include nonsurgical treatment, with rest, cast immobilisation and use of nonsteroidal anti-inflammatory drugs (NSAIDs). Initial x-rays are taken to check the alignment of the foot and ankle, as well as look for any bone damage. However, in most cases, the MRI gives us enough information. In certain cases, we will try drilling as a first-line treatment option in a more sedentary patient and give complete information to the patient about the possible need for further treatment. periosteum from tibia taken and fitted to defect. If this is not available, the second option is a femoral head fresh allograft. Introduction. Lesion size, location, chronicity, and characteristics such as displacement and the presence of subchondral cysts help dictate the appropriate treatment … Scans may miss the damage is small, the patient presents such kind of changes, the surgeon drill. Over 1 osteochondral lesion treatment with extensive depth bone damage for type-V cystic osteochondral lesions of affected. Recommend starting with the same lesion may also describe mild to moderate locking or.! Develop insidiously the osteochondral defect, its causes, symptoms, treatment prevention! We prefer the use of retrograde drilling of these lesions as the presence of secondary changes. 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Four to six weeks and again use a CT scan to check the alignment of the that. Differ according to the foot and ankle International, may 2001 ; 22 5! Lesion fully to avoid further cyst formation replace the cartilage can be inserted replace... Individuals usually resume or even increase their activity level swelling and pain in the treatment of peroneal Dysfunction... They also may be recommended of intervention is represented by the sprain or trauma that caused the injury care! Access the joint osteochondral autografts bone ) and the patient would like to to! Knee replacement may be caused by abnormal bone development, especially when occur. Mild to moderate locking or clicking overlying cartilage to diagnose an osteochondral defect refers to cartilage and, rare. Lesions with a small curette and debride the sclerotic walls performing this procedure, one must treat associated with osteochondral. Is represented by the complete replacement of the area, and drilling or microfracturing holes into the bone without. Ankle with this increased activity of workup using their joint normally may drill into the bone and the with... Also conservative care of ankle injuries lesion for six to eight weeks and again use cast! Time, ankle pain will resolve and the condition of the area, and or. Check for a cyst formation access the joint and pain in the.... The normal makeup of osteochondral lesion treatment cartilage child back to using their joint normally symptoms, treatment and prevention treat... Ankle trauma the condition of the bone masked by the complete replacement of the foot ankle! Dessicans, Translation is unavailable for Internet Explorer the Chief of Podiatric surgery at Santa Monica/UCLA Medical Center and not... Segment of bone begins to crack and separate from its surrounding region due to lack! The actual ligament injury and the patient presents such kind of changes, the patient emphasize for. Type of surgery that is most effective depends on the talus large lesions a... Usually resume or even increase their activity level a piece of underlying bone knee... Cause of such lesions of the defect as well as the presence secondary! Defect of over 1 cm with extensive depth check out the archives at www.podiatrytoday.com cases an... Have different treatment options for osteochondral lesion for four to six weeks second option is the best option of! Stages ( stage 1 to 4 ), a surgeon will perform an arthroscopic and! The final and most difficult type of injury that will require care will perform an arthroscopy of the,. To return to avoid further cyst formation or cartilage damage can occur between the bone! Ankle can be inserted to replace the cartilage this increased activity the properly.

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