Control post operative pain/swelling Treatment: - Patient to be progressed to PWB (up to 30% body weight) if a small lesion (per MD’s recommendations). What causes it? The most common joints affected by osteochondritis dissecans are the knee, ankle and elbow, although it can also occur in other joints. 1, in a review of >580 osteochondral defects … 1 The knee joint is perhaps one of the busiest joints in the body as it bears most of the body weight when standing. Editors: van Dijk, C. Niek, Kennedy, John G. 2015 Dec 18;6(11):944-53. doi: 10.5312/wjo.v6.i11.944. Treatment depends upon the size of the osteochondral defect and the condition of the overlying cartilage. However, it can be subdivided into a traumatic and nontraumatic cause. 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. 3-A) and heel-rise (Fig. Begin Range of Motion 4. 3-C). Osteochondral injuries of the talus are either idiopathic (osteochondritis dissecans) or related to a traumatic event (ankle sprain or fracture). 3 Radiographs of an ankle with a centromedial talar osteochondral defect at the time of follow-up. A subtle remnant of the defect (arrow) is visible on the anteroposterior mortise (Fig. This type of injury can be due to a severe ankle sprain that causes bone and cartilage to become loose, resulting in ongoing ankle pain. The graft is taken as a cylindrical plug of cartilage and subchondral bone. 3-B) views; the defect cannot be detected on the lateral view (Fig. The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. The ankle is plantarflexed to visualize the osteochondral defect (OCD). The treatment for an osteochondral defect of the talus is extremely varied and depends on the size of the defect … Osteochondral tissue harvested from fresh allograft talus and transplanted into the defect Best for large (>3 cm 2 ) lesions, as an alternative to arthrodesis ( 10 ) 66% success rate ( 11 ) Non-operative measures such as mobilisation, a heel lift and steroid injections are reasonable non-operative techniques to try before surgical referral, but pain from mechanical symptoms is often resistant to non-operative measures. 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 resulting in chronic pain in the knee and difficulties performing normal activities of daily living. 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. Definition. It may result in a defect that subsequently affects the subchondral bone and, in severe cases, may lead to formation of an osteochondral fragment. This allows us to treat the bone defect without affecting the cartilage. 6 The cause of OCLs of the talus has multiple facets. 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. He complains of mechanical symptoms with ankle movement that continue to be symptomatic with everyday activities. It is also called an osteochondral defect (OCD) or talar osteochondral lesion (OCL). 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). A talar osteochondral defect (OCD) is a combined lesion of the subchondral bone and its overlying cartilage. With disease progression, the fragment may detach, leading to degenerative osteoarthritis . Ankle: Chondral/Osteochondral Defect Repair ... 1. OCDs usually develop after an inversion or high impact injury to the ankle, leading to a portion of the cartilage to be injured. Talar dome lesions are usually caused by an injury, such as an ankle sprain. Sports Traumatol Arthrosc 18:570–580. Therapeutic arthroscopy with microfracture leads to fibrocartilaginous repair and is an effective treatment of osteochondral lesions of the talus. Osteochondral lesion (OCL) describes an injury to the articular cartilage surface of bone within a joint. Through the years members of Ankle Platform have asked for treatment advise. 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