What Is an Osteochondral Lesion of the Talus?
Your ankle plays an important role in your ability to do many tasks throughout the day. It takes on a lot of your weight when you’re up and about, so it’s no surprise that the bones and cartilage in your ankle can become damaged. One of the common causes of ankle instability is an osteochondral lesion of your talus bone.
Dr. Jeffrey McAlister at Phoenix Foot and Ankle Institute is a board-certified, fellowship trained, foot and ankle surgeon. If you’re having pain or trouble walking, Dr. McAlister examines your ankle and uses imaging studies to find out what’s causing the problem.
Anatomy of your talus
Your ankle is important to your ability to walk, climb stairs, and do just about any tasks on your feet. One of the most important bones in your ankle joint that allows all of these movements is your talus.
The talus bone is located between your heel bone and your lower leg bones. It’s basically the middle of your ankle joint that’s necessary for proper motion and movement. It transfers weight from your foot to your legs for mobility.
The talus receives most of its blood supply from your posterior tibial artery; but compared to other bones in your ankle, it doesn’t receive as much oxygenated blood. This means if you happen to injure your talus bone, it takes much longer for it to heal, because of the lack of oxygenated blood.
This bone is very prone to injury because it holds so much of your weight throughout the day. A fracture to your talus can cause a lot of problems with mobility. However, there’s another type of problem that’s also associated with your talus — an osteochondral lesion.
Osteochondral lesion of the talus — what is it?
Your talus bone is covered in a protective layer of cartilage that allows your ankle joint to move smoothly. The cartilage is very tough and helps protect the bone underneath from damage.
However, an injury to your ankle can damage the cartilage that’s protecting your talus. When this occurs, some of the cartilage can break off, damaging the talus bone underneath. This is called an osteochondral defect.
Osteo refers to the bone, while chondral means cartilage. Osteochondral lesions are basically a spot where both the bone and cartilage have been damaged, usually due to injury. So how do you know if you have an osteochondral lesion? There are a few signs that point to this problem, including:
- Ankle locking or giving out
- Pain that’s worse when you bear weight
- Ankle swelling that gets better with rest
- Ankle clicking while moving
In the case of your talus, an ankle sprain or a fracture to this bone can cause injury to the protective cartilage. Because of the decreased blood supply, it takes much longer for this type of injury to heal. If the cartilage doesn’t heal properly, it can wear down or break off, leaving your talus bone vulnerable to additional damage.
While this all seems pretty scary, we have treatment options available. Dr. McAlister helps you determine the severity of your osteochondral lesion and gets you the proper treatment to get you back on your feet.
Treatments that can help
If you find yourself in Dr. McAlister’s office with a diagnosis of an osteochondral lesion in your talus, you’re in good hands. Many different treatment options exist for this condition, and they’re dependent on the severity of the lesion, as well as if there’s loose cartilage or bone.
When your lesion doesn’t involve any loose bone or cartilage, Dr. McAlister suggests a more conservative approach to treatment. This may include options such as:
- Ankle brace
- Immobilization with a cast
- Physical therapy
- Anti-inflammatory medications
- Regenerative injections
If your lesion is stable, these therapies may be enough to heal the tissue and relieve your symptoms. However, sometimes these treatments just aren’t enough to give you the relief you need. In these cases, the doctor recommends surgical repair of the osteochondral lesion.
Dr. McAlister offers several different surgical repair options for an osteochondral lesion. The type of surgical repair you need is determined by the severity of the lesion and other damage you may have in your joint.
Many times, Dr. McAlister is able to repair an osteochondral lesion of your talus through a minimally invasive approach, which means smaller incisions and less pain after the procedure. This helps you start your recovery sooner, so you can get back to your life.
Current recommendations for osteochondral lesions over 1.5 cm² include arthroscopic debridement, drilling, bone marrow stimulation, cartilage restoration and ligament repair. Often times advanced techniques are utilized such as Ankle distraction to assist with cartilage repair. Our goal is to get you back on your feet as soon as possible.
If your ankle is bothering you, and you want treatment fast, call us at 602-761-7819 to schedule a consultation with Dr. McAlister, or book an appointment online with us today.