Osteochondral injuries

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What are osteochondral injuries?

OCLs (osteochondral lesions of the talus) consist of damage or minor fractures to cartilage’s surface on the lower bone of the talus (ankle joint).

This cartilage covers most of the talus, with the tibia (shin) and fibula (calf) bones above and to the sides of the talus making up the ankle joint. The joint enables the ankle to move in a vertical plane. Injuries don’t always heal as effectively here, because of the below-average blood supply to this area of the body.

Injuries include:

  • Cartilage damage
  • Cysts in the bone under the cartilage
  • Cartilage and bone fracture

What causes osteochondral injuries?

  • Most osteochondral injuries, including ankle sprains, occur by accident. Should the damage affect the talus in addition to another part of the joint like the tibia or fibula, this can compress or scuff the talus, leading to injury
  • Long-term wear and tear can also cause injury

What are the symptoms of osteochondral injuries?

Symptoms include:

  • Swelling and pain
  • A feeling that the joint is ‘catching’
  • Ankle instability
  • Ongoing pain and swelling, despite rest, after an ankle sprain

How are osteochondral injuries diagnosed?

At your initial meeting, your consultant will invite you to explain your symptoms and will then advise you on the most appropriate treatment. Normally X-rays and a CT or MRI scan to examine the ankle joint will be organised.

How are osteochondral injuries treated?

Immobilising and not allowing weight to be placed on the joint, followed by a course of physiotherapy can suffice in allowing the bone and cartilage to heal. Should this not be effective or in the case of serious injury, your consultant may recommend arthroscopic surgery to take away the injured cartilage and bone and remodel the bone’s surface to reduce pain and cut the risk of arthritis developing.