There is a slight male predominance in incidence of injury, To diagnose this injury, the foot and ankle surgeon will question the patient about recent or previous injury and will examine the foot and ankle, moving the ankle joint to help determine if there is pain, clicking, or limitation of motion within that joint. Treatment decisions are based upon the site and size of the lesion, the skeletal maturity of the patient, the quality of the articular cartilage, and the quality of the associated bone fragment. A varietyof surgical techniques is available to accomplish this. Lesion size, location, chronicity, and characteristics such as displacement and the presence of subchondral cysts help dictate the appropriate treatment … A retrospective study of 22 ankles in 22 patients with osteochondral talar dome lesions between 1975 and 1983 has indicated that surgical treatment yields superior results to conservative therapy. Treatment depends on the severity of the talar dome lesion. HOW TO TELL IF YOU HAVE A STRESS FRACTURE? The term osteochondritis dissecans was originally applied to lesions of the talar dome of the ankle by Kappis (, 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. TOENAIL FUNGAL INFECTIONS: UGLY, SPLIT AND DISCOLORED, Chronic pain deep in the ankle—typically worse when bearing weight on the foot (especially during sports) and less when resting, An occasional “clicking” or “catching” feeling in the ankle when walking, A sensation of the ankle “locking” or “giving out”, Episodes of swelling of the ankle—occurring when bearing weight and subsiding when at rest, Non-steroidal or steroidal anti-inflammatory medications. Systematic review of treatment strategies for osteochondral defects of the talar dome. Although one might expect a loose lesion to cause mechanical symptoms, complaints of locking, catching, or swelling are less common, except when a lateral lesion has caused an acute loose body to be formed. In this procedure an arthrotomy is performed through a 7 cm anteromedial or anterolateral incision. Conservative treatment of osteochondral lesions of the talus (OLTs) should be attempted first, whenever possible. Smaller diameter cysts would not accommodate the arthroscopic tools. 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). It was treated by curettage and autocorticocancellous bone grafting through an opening in the talonavicular joint without disturbing the intact talar dome cartilage. Surgery may involve removal of the loose bone and cartilage fragments within the joint and establishing an environment for healing. recommended fixation of the lesion larger than 7.5 mm . Baker CL, Andrews JR, Ryan JB. Stage 3 • Nondisplaced lesion with lucency: Stage 4 • Displaced fragment Surgical approaches include simple excision; excision with curettage; and excision, curettage, and drilling. ; ... Osteochondral lesions can occur in the talar head, body, and dome. The ankle joint is composed of the bottom of the tibia (shin) bone and the top of the talus (ankle) bone. 1999;15(1)77-84. Osteochondral lesions of the talus (OLTs) are a difficult pathologic entity to treat. Talar dome lesions generally involve either the superomedial or superolateral corners of the talus. Surgery may involve removal of the loose bone and cartilage fragments within the joint and establishing an environment for healing. Treatment for these complications is best directed by a foot and ankle surgeon and may include one or more of the following: Nonsteroidal or steroidal anti-inflammatory medications Physical therapy Bracing Surgical intervention [ Links ] 35. Sixteen patients (16 ankles) with symptomatic osteochondral lesions of the medial talar dome were treated arthroscopically with percutaneous retrograde drilling through the sinus tarsi. The patient will usually report a distinct episode of trauma when a lateral lesion is present, but with medial lesions there may be no specific injury or the common historical association of one or more ankle sprains in the past. Arthroscopic treatment of osteochondral lesions of the talus. J Bone Joint Surg Am. It was determined that the midmedial zone was the most common location (53%).