Foot and ankle orthopaedic specialists call this type of injury an OLT. 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. You should not have MP if the size of the OLT is too large for this technique, there is infection of the ankle joint or underlying bone, or your ankle is unstable. This reduces the chance that problems will occur. There may be pain and swelling after surgery, but the swelling usually subsides after one to two weeks. Once the unhealthy tissue is found, it is removed with a large drill to leave healthy bone underneath. Also read: [] This is a broad terminology that encompasses a variety of disorders including osteochondritis dissecans, osteochondral fractures, and osteochondral defects. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Successful Repair of Osteochondritis Dissecans: Sometimes Less Is More. Please click here to learn more about OCD of the Talus (Ankle… Your physician will provide you with the appropriate pain medication. for professional medical advice, diagnoses or treatments. The articulation of the talar dome and the trochlear surface (tibia and fibula) supports the weight of the body. Open 7 Days | Extended Hours | Tele-Visits Available, Cavus feet and flat feet can lead to uneven pressures in the ankle joint leading to early degenerative changes. Stitches will be removed once the swelling has decreased to a safe level, typically two to three weeks after surgery. May be due to micro trauma or a traumatic event. 880 Seven Hills Drive, Suite 150 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. Cast/boot immobilization for 6 weeks, followed by gradual return to activity. Left and right arrows move across top level links and expand / close menus in sub levels. Pain medication as needed every 6 hours. The tibia and fibula bones sit above and to the sides of the talus, forming the ankle joint. Ankle Arthroscopy + Microfracture Talus OCD (Osteochondritis Dissecans lesion) Day of Surgery A. Advanced arthritis throughout the ankle joint is another reason to avoid surgery. OCD is a type of osteochondrosis in which a lesion has formed within the cartilage layer itself, giving rise to secondary inflammation. 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. Much of this bone is covered with cartilage. If the lesion doesn’t heal, the child may develop joint pain that doesn’t go away. may be used for chronic cases to help heal the lesion. 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. Such lesions are a tear or fracture in the cartilage covering one of the bones in a joint. C. Icing is important for the first 5-7 days post-op. When will I be able to drive?You will be permitted to return to driving once you can walk without crutches and are able to react appropriately without pain of the ankle. 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. Enter Recovery: Average recovery time after undergoing surgery to repair an osteochondral lesion of the talus ranges from four to six weeks. Your surgeon may perform retrograde drilling of the lesion, ankle arthroscopy of the ankle joint, osteochondral transplant autograft/allograft. Amniotic cell therapy contains growth factors and stem cells which have shown to accelerate healing. An adult who had OCD as a child may be more likely to develop arthritis. In the knee, such … This will encourage healing of the surrounding bone. May be due to micro trauma or a traumatic event. 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. Many cases of ankle OCD are difficult to fully resolve and some will need more than one surgery. What are the long-term concerns? Treating osteochondral lesions of the talus can pose challenges and delayed diagnosis due to late presentation after an ankle sprain. Left untreated this can lead to degenerative changes to the ankle joint and evan necrosis of the talus. These authors evaluate the effectiveness of procedures such as microfracture and arthroscopy, and recent innovations such as juvenile particulate chondrocyte allografts. This gives the repaired surface the appearance of a mosaic. Once the piece has broken off, surgery is almost always necessary. This is known as an autograft. 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). Which joints are most commonly affected by OCD? MP might be considered if you continue to have symptoms after non-surgical treatment. Osteochondral lesion of the talus (OLT) is a broad term used to describe an injury or abnormality of the talar articular cartilage and adjacent bone. Osteochondral lesions of the talus (OLT) are ankle joint injuries involving damage to the joint surface (cartilage) and/or underlying ankle bone (talus). A bandage is placed around the incision sites. 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. Research studies show OCD lesion in the talus in 70% of ankle fractures, 60% of ankle sprains. American Orthopaedic Foot & Ankle Society, The American Orthopaedic Foot & Ankle Society (AOFAS) offers information on this site as an educational service. Tab will move on to the next part of the site rather than go through menu items. Drilling into the lesion to create pathways for new blood vessels to nourish the affected area. D. Make sure … The American Orthopaedic Foot & Ankle Society (AOFAS) offers information on this site as an educational service. Other ways to decrease pain and swelling include resting, icing and elevating the affected limb above the level of the heart, especially during the first two weeks. In this video, I discuss the types of surgery and how you might recover from those surgeries. [] Although … There are different surgical techniques for treating OCD, depending upon the individual case. Recovery and surgery for an OCD lesion of the knee. Physical therapy is done to help with range of motion and peroneal tendon strengthening. The aproach can best be by anterior arthroscopy. B. MP might be considered if you continue to have symptoms after non-surgical treatment. One way to treat the damaged ankle cartilage is through surgery. Patients are advised to keep all weight off the operated leg for four to six weeks after surgery. Care must be taken with icing to avoid frostbite. Where will the healthy cartilage transplant come from?There are two sources of graft. Diet as tolerated. What is an osteochondral lesion of the talus (OLT, OCD, Osteochondritis Dessicans)? Typical risks include pain that does not go away after the surgery (in the donor joint or the ankle), swelling, numbness, tingling, stiffness, non-healing of the transplanted tissue, and poor healing of the area from where the transplant was taken. arthroscopic harvest of chondrocytes (from ankle or alternatively from knee) are sent for cultured growth; open approach via osteotomy for implantation; instrumentation debridement of lesion to create stable cartilage rim, subchondral bone exposed; bone graft may be placed if underlying cyst and bone loss OCD (osteochondritis dissecans), on the other hand, is considered a chronic process that can go on for months to years before any symptoms are felt. An osteochondral ankle defect is a lesion of the talar cartilage and subchondral bone mostly caused by a single or multiple traumatic events, leading to partial or complete detachment of the fragment. 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 … Physical therapy is done to help with range of motion and peroneal tendon strengthening. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). 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. INTRODUCTION. How much will this procedure hurt?This procedure can cause some discomfort. 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. Ice is applied for 20-minute periods 3-4 times per day. More than 90 percent of individuals undergoing this procedure have good to excellent results. The percentage of all OCD lesions progressing to surgery was 35.3%; surgical progression for knee, ankle, and elbow joints was 33.5%, 31.8%, and 55.0%, … and space open menus and escape closes them as well. This condition is also known as osteochondritis dissecans (OCD) of the talus or a talar osteochondral lesion (OCL). This is an injury of the protective cartilage on the top of the talus (the ankle bone). Symptomatic osteochondral ankle defects often require surgical treatment. After this, the patient can begin physical therapy to regain strength and motion of the ankle. Osteochondral lesions of the talus (OLT) are those that affect the chondral and subchondral areas of the talus. The content of FootCareMD, including text, images, and graphics, is for informational purposes only. The type of surgery needed will depend on the stage and size of the … If you bring the ankle in forced plantar flexion you will see the defect. This is a typical case of posteromedial OCD. Holding the lesion in place with internal fixation (such as pins and screws). You’ll find this cartilage where the talus touches the tibia and fibula (the bones of the lower leg). Osteochondral lesion also known as OCD or Osteochondritis dissecans is the injury to the cartilage and subchondral bone. All rights reserved. It is important to place the transplant tissue so that it produces a smooth surface. 2 UWSPORTSMEDICINE.ORG 621 SCIENCE DRIVE • MADISON, WI 53711 ... OCD heals after surgery. “Osteo” means bone and “chondral” refers to … The orthopaedic surgeon makes incisions on the ankle to access the injured area. Figure 2 MRI view of an OCD lesion of the knee. Ankle Osteochondritis Dissecans. This joint permits much of the up (dorsiflexion) and down (plantarflexion) motion of the foot and ankle. 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. Fibrocartilage is a tough, dense, fibrous material that can fill in areas where smooth, glassy cartilage has become damaged or worn away. OCD lesions can develop when the area of bone beneath the cartilage is injured. During recovery, you should call your foot and ankle orthopaedic surgeon if you experience excessive bleeding, fever or chills, redness that expands from the incision site, continuous severe pain, new numbness of the foot or nausea, and vomiting that do not resolve with medication. They may also be found in the talus bone in the ankle. This condition is also known as either osteochondritis dissecans (OCD) of the talus or as a talar osteochondral lesion (OCL). Osteochondritis Dissecans (OCD) is a condition that develops in the joints, most often in children and adolescents. X-rays, MRI, CT and Bone scans may be performed to confirm the diagnosis of OCD (osteochondral lesion) and monitor its progression. In children, they are most often found in the knee and elbow. [email protected] The content is not intended to substitute With treatment, OCD often heals well. 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 … This is reserved for lesions that are attached with minimal displacement. OCD most commonly affects the knee, although it can affect other joints such as the ankle or the elbow. 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. It is recommended that you avoid bearing weight … The talus is a bone in the foot that makes up the bottom part of the ankle joint. 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. 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. Sometimes an ankle injury leads to damaged, rough areas of cartilage and bone underneath. Preventing OCD Ankle Injuries. When Surgery Becomes Necessary There are situations where OCD becomes problematic enough to warrant arthroscopic surgery to remove the lesion. 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). Preventing osteochondral lesions means avoiding traumatic ankle … The second comes from a deceased donor’s body. The content is not intended to substitute Treatment is by debridement and bone marrow stimulation. Otherwise consultation with a physician specializing in treating OCD lesions (such as a ROCK member) may be helpful. Osteochondral lesions or osteochondritis dessicans can occur in any joint, but are most common in the knee and ankle. Young patients with a skeleton that is not yet mature typically do not have this surgery, nor should elderly patients with medical problems that would complicate recovery. A normal, healthy ankle joint is made up of smooth cartilage supported by strong bone underneath. Amniotic cell therapy may be used for chronic cases to help heal the lesion. Surgery may involve removal of the loose bone and cartilage fragments within the joint and establishing an environment for healing. Posterior Tibial Tendon Dysfunction (PTTD). The surgeon may choose to perform lateral ankle stabilization surgery to prevent recurrence. X-rays of the ankle are routinely obtained but may not identify an OCD in almost 50% of cases. Osteochondral lesion also known as OCD or Osteochondritis dissecans is the injury to the cartilage and subchondral bone. The talus is the bottom bone of the ankle joint. Patients with other health problems may stay in the hospital for a longer period of time. Discussions with your surgeon should help figure out how to proceed if your previous surgery was not successful. Up and Down arrows will open main level menus and toggle through sub tier links. for professional medical advice, diagnoses or treatments. The healthy tissue is transplanted into holes in the ankle joint until it forms a smooth surface. Your surgeon will select the best procedure to repair the OCD lesion which may involve removal of the loose bone and cartilage fragment as well as arthroscopically cleaning the joint of any inflammation. You cannot drive if you are taking narcotic pain medications. Top. The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. It is kind of like having a pothole in the joint surface. One type of surgery is called mosaicplasty (MP), which is the transplant of small amounts of bone and cartilage. There are multiple surgical interventions for those lesions that have failed conservative therapy or have OCD lesions which are displaced. Henderson, NV 89052 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). Your doctor may also recommend exercises or physical therapy to improve range of motion, strength and function. 3,7,17,43,47 Treatments 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. There are a number of treatment options. Recovery from osteochondritis dissecans ankle surgery is likely to involve keeping your weight off the ankle for a time. © 2020 Laser Foot Surgery Centers, LLC. The site navigation utilizes arrow, enter, escape, and space bar key commands. Get Directions, (833) 693-3381 Osteochondritis dissecans of the ankle Dr Mostafa El-Feky ◉ and Dr Bruno Di Muzio ◉ ◈ et al. Research studies show OCD lesion in the talus in 70% of ankle fractures, 60% of ankle sprains. It is often associated with a … A variety of terms have been used to refer to this clinical entity, including osteochondritis dissecans (OCD), osteochondral fracture and osteochondral defect. The first comes from a healthy site in the patient’s own body. 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… If you need medical advice, use the "Find a Surgeon" search to locate a foot and ankle orthopaedic surgeon in your area. It is completely covered in cartilage and allows for smooth ankle motion. The knee, ankle and elbow are the most commonly affected joints. 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. MP generally is safe but there are potential complications that can occur during and after treatment for an OLT. If you need medical advice, use the ", Mosaicplasty for Osteochondral Lesions of the Talus. This procedure may be performed with general or regional anesthesia. This is called an allograft. This is reserved for lesions that are attached with minimal displacement. The content of FootCareMD, including text, images, and graphics, is for informational purposes only. The surgical procedure will be chosen by the surgeon based on the physical exam and radiographic findings. dissecans (OCD) most often affects the knee, ankle and elbow. 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. Once the procedure is finished, the surgeon closes the openings with stitches. After surgery, your child will use crutches for 1 to 3 months to allow the joint to heal. If the fractured bone has completely detached, it can get caught between joints, causing pain. Since the ankle joint moves while walking, the rough spots may cause pain, swelling, stiffness, and decreased motion. The risk of infection and poor healing are much higher for patients who have uncontrolled diabetes or those who smoke. When the talus is injured, the bone and cartilage can be damaged, creating an osteochondral lesion … This minimally-invasive procedure is performed to stimulate the growth of fibrocartilage in an injured joint. All surgeries come with possible complications, including the risks associated with anesthesia, infection, damage to nerves and blood vessels, and bleeding or blood clots. The defects cause deep ankle pain associated with weight… The medial facets of the talar dome articulate with the medial malleol… Cast/boot immobilization for 6 weeks, followed by gradual return to activity. An osteochondral lesion can be a painful problem. People with OCD report activity-related pain that develops gradually. By reconstructing the surface, pain and other symptoms should decrease or stop all together. 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