Osteochondral Lesion of Talus
What is an osteochondral lesion of the talus (OLT, OCD, Osteochondritis Dessicans)?
The talus is a bone in the foot that makes up the bottom part of the ankle joint. It is completely covered in cartilage and allows for smooth ankle motion. When the talus is injured, the bone and cartilage can be damaged, creating an osteochondral lesion of the talus.
What causes osteochondral lesions of the talus?
Osteochondral lesions of the talus are often caused by injuries to the ankle such as ankle sprains and ankle fractures. Some talus osteochondral lesions arise without a known trauma.
What are the symptoms of osteochondral lesions of the talus?
Symptoms of osteochondral lesions of the talus tend to gradually worsen and include pain, swelling, clicking or catching when walking, and instability or giving out of the joint.
How are osteochondral lesions of the talus diagnosed?
Osteochondral lesions of the talus are diagnosed with a medical history, thorough physical examination, X-rays, CT and MRI. CT is used to accurately diagnose the size of the lesion and to assess for fragments and cysts. MRI is the best modality to evaluate the cartilage and bone edema.
How are osteochondral lesions of the talus treated?
Treatment for osteochondral lesions of the talus begin with conservative care consisting of immobilization, restricted weight bearing, nonsteroidal anti-inflammatory drugs, physical therapy, bracing and injections.
If conservative management fails to relieve the symptoms and in severe cases surgery may be needed. Surgery involves removing damaged bone and cartilage. Surgical techniques include microfracture, grafting of cartilage and bone, and fixing the loose fragment with screws.