Submissions are anonymized and transformed to cases which you can find in this section. Keywords Osteochondral defect Cartilage Ankle joint Subchondral cyst Natural history Pain Introduction An osteochondral defect (OD) of the talus is a lesion involving the talar articular cartilage and its subchondral bone mostly caused by a single or multiple traumatic events, but idiopathic OD of the ankle do occur [8, 46, 47, 50]. With disease progression, the fragment may detach, leading to degenerative osteoarthritis . It is also called an osteochondral defect (OCD) or talar osteochondral lesion (OCL). How is it caused? Therefore a small anteromedial synovectomy is done using a 5.5 mm bonecutter shaver with the ankle in the dorsiflexed position. Knee Surg. A talar osteochondral defect (OCD) is a combined lesion of the subchondral bone and its overlying cartilage. Clinical Relevance: The location of peak stress in the ankle joint becomes closer to the rim of the defect in OLTs at a threshold of 10 mm and greater in diameter. We prefer to use the broader term osteochondral lesion to define a lesion of any origin … Because of excessive overlying fibrous tissue and synovium, the defect cannot be adequately visualized. Physicians can upload their anonymized problem case for expert advice. [] Although majority may be associated with trauma, some may develop insidiously. It is then matched to the surface area of the defect and impacted into place. These data may have implications toward OLT size thresholds for surgical decision making in symptomatic lesions (ie, primary osteochondral transplantation procedure vs curettage and debridement). Osteochondral defects . In many cases of OCD in children, the affected bone and cartilage heal on their own, especially if a child is still growing. The most common joints affected by osteochondritis dissecans are the knee, ankle and elbow, although it can also occur in other joints. Osteochondral lesions are injuries to the talus (the bottom bone of the ankle joint) that involve both the bone and the overlying cartilage. There is a wide variety of treatment strategies for osteochondral defects of the ankle, with new techniques that have substantially increased over the last decade. If the fragment has come loose, it can also cause locking or instability symptoms. “Osteo” means bone and “chondral” refers to cartilage. Osteochondral defects in the ankle: why painful? INTRODUCTION. Osteochondral defects and loose bodies are common causes of mechanical symptoms in the ankle. Begin Range of Motion 4. However, it can be subdivided into a traumatic and nontraumatic cause. Epidemiologically, the ankle registers 4% of all the human osteochondral defects. These injuries may include softening of the cartilage layers, cyst-like lesions within the bone below the cartilage, or fracture of the cartilage and bone layers. 1, in a review of >580 osteochondral defects … 70 Patients suffering from these defects typically experience persistent or intermittent deep ankle pain during or after activity. In acute conditions, symptoms of osteochondral ankle defects are similar to those of acute ankle injuries. 6 The cause of OCLs of the talus has multiple facets. Tol et al. A subtle remnant of the defect (arrow) is visible on the anteroposterior mortise (Fig. Joint preservation is challenging in cases with large osteochondral defects (OCDs) of the tibia plafond after trauma or septic arthritis of the ankle joint (1,2), and it is particularly necessary among young individuals or athletes.Several treatment strategies—namely, arthrodesis, osteochondral allograft, and total ankle replacement (TAR)—have been described for large OCDs of the ankle (). 31. van Dijk CN, Verhagen RA, Tol JL (1997) Arthroscopy for. Immobilization of the ankle, medications, steroid injections and physical therapy are commonly tried but this often fails to relieve symptoms and surgery may be required. A full diagnostic arthroscopy is performed, and then attention is turned to the osteochondral defect. During loading, compressed cartilage … If the cartilage does not heal properly following the injury, it softens and begins to break off. The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. (Eds.) This allows us to treat the bone defect without affecting the cartilage. The broad term “osteochondral lesion of the talus” describes an injury or abnormality of the talar articular cartilage and adjacent bone.1 We can describe lesions as a cartilage defect, bone cyst or subchondral bone cyst. Osteochondral Defects in the articular cartilage can result from trauma, arthritic conditions, chronic wear and tear. The graft is taken as a cylindrical plug of cartilage and subchondral bone. They may also be called osteochondritis dessicans or osteochondral fractures. The treatment for an osteochondral defect of the talus is extremely varied and depends on the size of the defect … The development of a symptomatic OD depends on various factors, including the damage and insufficient repair of the subchondral bone plate. 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