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Management Options For Osteochondral Lesions Of The Ankle

If your ankle is swollen, painful or you notice a clicking sound at times when walking, especially after suffering trauma to the area, there’s a possibility that you’re dealing with an osteochondral lesion. An osteochondral lesion occurs when you suffer damage to the protective cartilage at the bottom of your ankle joint near a bone called the talus. Your talus is the second largest bone in your hindfoot, as only your heel bone (calcaneus) is larger, and the talus plays a major role in supporting your body weight and ensuring smooth movement of the ankle joint.

Needless to say, damage to this protective cartilage can disrupt this smooth motion and make movement uncomfortable or even downright painful. In today’s blog, we take a closer look at how Dr. McDonald can help you treat an osteochondral lesion in your ankle.

Causes And Symptoms Of Osteochondral Lesions

As we alluded to in the introduction, osteochondral lesions most commonly develop following significant trauma to the ankle region. A severe sprain or a high-energy injury like you may experience during a fall or a car accident are oftentimes enough to damage the cartilage around the talus. Although trauma to the ankle is the most common underlying cause of osteochondral lesions, certain foot shapes or genetics may put you at a heightened risk for expedited cartilage degeneration. 

When this cartilage becomes torn or rigid, ankle movement can become disjointed. That’s why the most common symptoms associated with osteochondral lesions include:

  • Pain or discomfort when walking or flexing the ankle
  • An audible clicking or cracking sound when moving the ankle
  • Inhibited range of ankle motion
  • A sensation that your ankle is catching during movement

If you are experiencing any of these symptoms, especially if you have recently made progress in recovering from an ankle injury, reach out to a foot and ankle specialist like Dr. McDonald.

Diagnosing And Treating Osteochondral Lesions

If you present with the above symptoms and your medical history or a conversation with your specialist reveals that you recently suffered ankle trauma, your doctor will begin to hone in on the possibility that you have a troublesome osteochondral lesion brewing beneath the surface. They’ll start by conducting a physical exam of the area and will likely manipulate the ankle with their hands or ask you to perform some simple movements to see how your ankle responds to these stresses. From there, they’ll likely work to confirm their suspicions with the help of an imaging exam. An X-ray, MRI or CT scan can all provide invaluable insight into the inner workings of your ankle joint and cartilage health.

If an osteochondral lesion is confirmed, your foot specialist will most likely chart a non-operative course of treatment. Some common conservative treatments that may be used in conjunction with one another include:

  • Rest/Activity Modification
  • Casting
  • Anti-Inflammatory Medications
  • Physical Therapy
  • Corticosteroid Injections

For many mild to moderate cases, patients experience enough relief through physical therapy and other techniques listed above that no further treatment is required. However, if treatment fails to provide enough relief, your specialist may talk to you about your surgical options. Your surgeon may move forward with a standard debridement procedure to clean up or remove damaged sections of cartilage, or they may attempt to promote bone healing in the area through bone drilling or bone grafts, which can make the talar complex stronger and more functional. Your doctor can explain each operation in greater detail should it come to this, but oftentimes conservative care can do the trick.

For more information about osteochondral lesions or caring for a lingering foot and ankle issue after an initial injury, reach out to Dr. McDonald and his team today at (860) 244-8889.

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