Left untreated this can lead to degenerative changes to the ankle joint and evan necrosis of the talus. Fibrocartilage is a tough, dense, fibrous material that can fill in areas where smooth, glassy cartilage has become damaged or worn away. More than 90 percent of individuals undergoing this procedure have good to excellent results. Ankle > Osteochondral Lesion of the Talus > Treatments Arthroscopic Surgery Treatment introduction Your physician can use an arthroscope - a tiny camera with about a three to five millimeter diameter - to take a look at the top of your talus in the ankle … Once the unhealthy tissue is found, it is removed with a large drill to leave healthy bone underneath. Will I regain all of my original function in my ankle joint?After your ankle has had time to heal you will start physical therapy for ankle range of motion and strength to regain the function you had prior to surgery. Ankle instability or giving way; Stiffness of the ankle; Difficulty with walking, running, or sports; A foot and ankle specialist can diagnose an osteochondral injury of the talus by taking a medical history and conducting a physical exam. The articulation of the talar dome and the trochlear surface (tibia and fibula) supports the weight of the body. X-rays, MRI, CT and Bone scans may be performed to confirm the diagnosis of OCD (osteochondral lesion) and monitor its progression. 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). Surgery also might be considered if an OLT completely detaches from the ankle bone and/or begins to move around in the joint space, causing locking and catching. The majority of joints needing surgery were in the knee (58.5%), with ankle and elbow lesions representing 22.9% and 18.6% of surgeries performed, respectively. There are multiple surgical interventions for those lesions that have failed conservative therapy or have OCD lesions which are displaced. may be used for chronic cases to help heal the lesion. It is often associated with a … People with OCD report activity-related pain that develops gradually. Enter In the knee, such … This is reserved for lesions that are attached with minimal displacement. The site navigation utilizes arrow, enter, escape, and space bar key commands. This reduces the chance that problems will occur. Recovery: Average recovery time after undergoing surgery to repair an osteochondral lesion of the talus ranges from four to six weeks. The second comes from a deceased donor’s body. Amniotic cell therapy may be used for chronic cases to help heal the lesion. Surgery also might be considered if an OLT completely detaches from the ankle bone and/or begins to move around in the joint space, causing locking and catching. Ankle Osteochondritis Dissecans. Care must be taken with icing to avoid frostbite. This will encourage healing of the surrounding bone. The content of FootCareMD, including text, images, and graphics, is for informational purposes only. Posterior Tibial Tendon Dysfunction (PTTD). With treatment, OCD often heals well. MP might be considered if you continue to have symptoms after non-surgical treatment. If you bring the ankle in forced plantar flexion you will see the defect. If the lesion doesn’t heal, the child may develop joint pain that doesn’t go away. for professional medical advice, diagnoses or treatments. When the talus is injured, the bone and cartilage can be damaged, creating an osteochondral lesion … Cast/boot immobilization for 6 weeks, followed by gradual return to activity. X-rays of the ankle are routinely obtained but may not identify an OCD in almost 50% of cases. When can I go back to exercising or sports?Although returning to activity is based on the individual patient’s progress as well as the surgeon’s expert opinion, most people can begin to increase activity as tolerated by 10-12 weeks. Osteochondritis Dissecans (OCD) is a condition that develops in the joints, most often in children and adolescents. The talus is a bone in the foot that makes up the bottom part of the ankle joint. An adult who had OCD as a child may be more likely to develop arthritis. What are the long-term concerns? The orthopaedic surgeon makes incisions on the ankle to access the injured area. Once the procedure is finished, the surgeon closes the openings with stitches. Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. The American Orthopaedic Foot & Ankle Society (AOFAS) offers information on this site as an educational service. One way to treat the damaged ankle cartilage is through surgery. Research studies show OCD lesion in the talus in 70% of ankle fractures, 60% of ankle sprains. One type of surgery is called mosaicplasty (MP), which is the transplant of small amounts of bone and cartilage. Surgery may involve removal of the loose bone and cartilage fragments within the joint and establishing an environment for healing. Ankle Arthroscopy + Microfracture Talus OCD (Osteochondritis Dissecans lesion) Day of Surgery A. D. Make sure … Tab will move on to the next part of the site rather than go through menu items. A variety of terms have been used to refer to this clinical entity, including osteochondritis dissecans (OCD), osteochondral fracture and osteochondral defect. Holding the lesion in place with internal fixation (such as pins and screws). Will I have to stay overnight in the hospital after the surgery?Most healthy patients will be able to leave the hospital after surgery as long as they can take medication by mouth and their pain is under control. After this, the patient can begin physical therapy to regain strength and motion of the ankle. What is an osteochondral lesion of the talus (OLT, OCD, Osteochondritis Dessicans)? Foot and ankle orthopaedic specialists call this type of injury an OLT. Preventing OCD Ankle Injuries. Osteochondral lesions of the talus (OLT) are ankle joint injuries involving damage to the joint surface (cartilage) and/or underlying ankle bone (talus). All surgeries come with possible complications, including the risks associated with anesthesia, infection, damage to nerves and blood vessels, and bleeding or blood clots. C. Icing is important for the first 5-7 days post-op. May be due to micro trauma or a traumatic event. The surgical procedure will be chosen by the surgeon based on the physical exam and radiographic findings. INTRODUCTION. 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). The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. Diet as tolerated. A normal, healthy ankle joint is made up of smooth cartilage supported by strong bone underneath. Discussions with your surgeon should help figure out how to proceed if your previous surgery was not successful. [] Although … A bandage is placed around the incision sites. This gives the repaired surface the appearance of a mosaic. Will taking cartilage from other joints in my body cause long-term problems?The graft that is harvested is removed from a place in the healthy joint that has little weight bearing. OCD most commonly affects the knee, although it can affect other joints such as the ankle or the elbow. They may also be found in the talus bone in the ankle. Cast/boot immobilization for 6 weeks, followed by gradual return to activity. You’ll find this cartilage where the talus touches the tibia and fibula (the bones of the lower leg). The first comes from a healthy site in the patient’s own body. Successful Repair of Osteochondritis Dissecans: Sometimes Less Is More. and space open menus and escape closes them as well. For osteochondritis dissecans (OCD) of the knee, avascular necrosis of subchondral bone can lead to fragmentation of bone and overlying cartilage [Figure 1]; osteochondral loose body formation may occur, leading to pain and further … Get Directions, (833) 693-3381 There are a number of treatment options. The surgeon may choose to perform lateral ankle stabilization surgery to prevent recurrence. The aproach can best be by anterior arthroscopy. [] This is a broad terminology that encompasses a variety of disorders including osteochondritis dissecans, osteochondral fractures, and osteochondral defects. American Orthopaedic Foot & Ankle Society, The American Orthopaedic Foot & Ankle Society (AOFAS) offers information on this site as an educational service. This procedure may be performed with general or regional anesthesia. The tibia and fibula bones sit above and to the sides of the talus, forming the ankle joint. Symptomatic osteochondral ankle defects often require surgical treatment. The talar dome is a trapezoid-shaped protuberance of the talus, 2.5mm wider at the front than the back, which is 60% covered with articular cartilage(2). The knee, ankle and elbow are the most commonly affected joints. Also, if an OLT is too large to heal on its own but small enough to allow for the transplantation of new tissue, surgery might be an option. Since the ankle joint moves while walking, the rough spots may cause pain, swelling, stiffness, and decreased motion. info@laserfootsurgerycenters.com. There are different surgical techniques for treating OCD, depending upon the individual case. Stitches will be removed once the swelling has decreased to a safe level, typically two to three weeks after surgery. Your physician will provide you with the appropriate pain medication. Your surgeon may perform retrograde drilling of the lesion, ankle arthroscopy of the ankle joint, osteochondral transplant autograft/allograft. It may require multiple plugs to fill the gaps in the ankle surface. Osteochondritis dissecans (OCD) of the talus (ankle bone) happens when repetitive trauma results in a blood supply injury to the talus and the bone either fails to develop from the cartilage your kid was born with, or the maturing bone dies and therefore softens and collapses. Physical therapy is done to help with range of motion and peroneal tendon strengthening. It is recommended that you avoid bearing weight … This joint permits much of the up (dorsiflexion) and down (plantarflexion) motion of the foot and ankle. The blood supply to the talus is not as rich as many other bones in the body, and as a result injuries to the talus sometime… Osteochondral lesion also known as OCD or Osteochondritis dissecans is the injury to the cartilage and subchondral bone. Surgery for Osteochondritis Dissecans of the Foot and Ankle When OCD is too severe and non-surgical treatment does not work, we may recommend surgery. MP generally is safe but there are potential complications that can occur during and after treatment for an OLT. Advanced arthritis throughout the ankle joint is another reason to avoid surgery. Trauma- seen with ankle fractures and sprains, Foot Deformity- Cavus feet and flat feet can lead to uneven pressures in the ankle joint leading to early degenerative changes, Pain with range of motion of the ankle joint. In this video, I discuss the types of surgery and how you might recover from those surgeries. May be due to micro trauma or a traumatic event. Many cases of ankle OCD are difficult to fully resolve and some will need more than one surgery. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). When Surgery Becomes Necessary There are situations where OCD becomes problematic enough to warrant arthroscopic surgery to remove the lesion. Ice is applied for 20-minute periods 3-4 times per day. Osteochondritis dissecans of the ankle Dr Mostafa El-Feky ◉ and Dr Bruno Di Muzio ◉ ◈ et al. Treatment is by debridement and bone marrow stimulation. If the fractured bone has completely detached, it can get caught between joints, causing pain. Please click here to learn more about OCD of the Talus (Ankle… Amniotic cell therapy contains growth factors and stem cells which have shown to accelerate healing. OCD is estimated at 15 to 21 per 100 000.27 Lesions most fre- quently occur on the femoral condyles, but they are also found in the elbow, wrist, ankle, and femoral head. The talus is the bottom bone of the ankle joint. This minimally-invasive procedure is performed to stimulate the growth of fibrocartilage in an injured joint. By reconstructing the surface, pain and other symptoms should decrease or stop all together. All rights reserved. This condition is also known as osteochondritis dissecans (OCD) of the talus or a talar osteochondral lesion (OCL). The defects cause deep ankle pain associated with weight… Surgery is typically an outpatient procedure (day surgery) and scheduled at your convenience. The content is not intended to substitute The risk of infection and poor healing are much higher for patients who have uncontrolled diabetes or those who smoke. 3,7,17,43,47 Treatments The procedure includes removing graft tissue from the knee joint on the same side as the damaged ankle joint or obtaining it from a tissue donor. Much of this bone is covered with cartilage. “Osteo” means bone and “chondral” refers to … The medial facets of the talar dome articulate with the medial malleol… It is completely covered in cartilage and allows for smooth ankle motion. Drilling into the lesion to create pathways for new blood vessels to nourish the affected area. It is kind of like having a pothole in the joint surface. The primary goal of this procedure is to smooth out the surface of the ankle joint by replacing the unhealthy spots with healthy, smooth cartilage. Figure 2 MRI view of an OCD lesion of the knee. OCD lesions can develop when the area of bone beneath the cartilage is injured. How much will this procedure hurt?This procedure can cause some discomfort. This is called an allograft. Patients with other health problems may stay in the hospital for a longer period of time. 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