OCDs or Osteochondral Defects/Lesions
When surgery is considered for these injuries, usually minimally invasive techniques such as arthroscopy can be utilized.
Osteochondral defects or lesions of the ankle are injuries to the cartilage and underlying bone of the joint surfaces. There are several names given to this entity including osteochondral defects (OCDs), osteochondral lesions of the talus (OLTs), or osteochondritis dissecans(OCDs). They most commonly involve the top surface of the talus, which is the bone situated under the tibia (shin bone). The injury can be caused from ankle sprains, falls, or any type of twisting or impaction injury to the joint. The cartilage and/or underlying bone becomes damaged. OCDs are often diagnosed many months after an injury due to continued pain after conservative treatment. At times, there is no specific history of injury. They can occasionally be seen on Xray, but often a MRI is needed in order to make the diagnosis.
Pain is usually described as deep in the ankle joint and worse with weight bearing activities. Catching, locking, giving way, and intermittant swelling are also common.
Non-operative treatment consists of activity modifications, ice, anti-inflammatory medications, immobilization (boot or cast), physical therapy, bracing, and periods of non-weight bearing. When surgery is considered, usually minimally invasive techniques such as arthroscopy can be utilized. There are varied surgical techniques and procedures available depending on the size, location, and depth of the OCD as well as patient age and activity level.