Other ways to decrease pain and swelling include resting, icing and elevating the affected limb above the level of the heart, especially during the first two weeks. When Surgery Becomes Necessary There are situations where OCD becomes problematic enough to warrant arthroscopic surgery to remove the lesion. When will I be able to drive?You will be permitted to return to driving once you can walk without crutches and are able to react appropriately without pain of the ankle. and space open menus and escape closes them as well. Research studies show OCD lesion in the talus in 70% of ankle fractures, 60% of ankle sprains. Up and Down arrows will open main level menus and toggle through sub tier links. Amniotic cell therapy contains growth factors and stem cells which have shown to accelerate healing. When the talus is injured, the bone and cartilage can be damaged, creating an osteochondral lesion … American Orthopaedic Foot & Ankle Society, The American Orthopaedic Foot & Ankle Society (AOFAS) offers information on this site as an educational service. D. Make sure … This gives the repaired surface the appearance of a mosaic. The content is not intended to substitute Surgery for Osteochondritis Dissecans of the Foot and Ankle When OCD is too severe and non-surgical treatment does not work, we may recommend surgery. Fibrocartilage is a tough, dense, fibrous material that can fill in areas where smooth, glassy cartilage has become damaged or worn away. This is reserved for lesions that are attached with minimal displacement. Surgery may involve removal of the loose bone and cartilage fragments within the joint and establishing an environment for healing. Also, if an OLT is too large to heal on its own but small enough to allow for the transplantation of new tissue, surgery might be an option. Your surgeon will select the best procedure to repair the OCD lesion which may involve removal of the loose bone and cartilage fragment as well as arthroscopically cleaning the joint of any inflammation. Once the piece has broken off, surgery is almost always necessary. This will encourage healing of the surrounding bone. Typical risks include pain that does not go away after the surgery (in the donor joint or the ankle), swelling, numbness, tingling, stiffness, non-healing of the transplanted tissue, and poor healing of the area from where the transplant was taken. Preventing OCD Ankle Injuries. A variety of terms have been used to refer to this clinical entity, including osteochondritis dissecans (OCD), osteochondral fracture and osteochondral defect. In children, they are most often found in the knee and elbow. [] This is a broad terminology that encompasses a variety of disorders including osteochondritis dissecans, osteochondral fractures, and osteochondral defects. One way to treat the damaged ankle cartilage is through surgery. Sometimes an ankle injury leads to damaged, rough areas of cartilage and bone underneath. Holding the lesion in place with internal fixation (such as pins and screws). Osteochondral lesion also known as OCD or Osteochondritis dissecans is the injury to the cartilage and subchondral bone. The talar dome is a trapezoid-shaped protuberance of the talus, 2.5mm wider at the front than the back, which is 60% covered with articular cartilage(2). Care must be taken with icing to avoid frostbite. Successful Repair of Osteochondritis Dissecans: Sometimes Less Is More. Will I have to stay overnight in the hospital after the surgery?Most healthy patients will be able to leave the hospital after surgery as long as they can take medication by mouth and their pain is under control. By reconstructing the surface, pain and other symptoms should decrease or stop all together. The primary goal of this procedure is to smooth out the surface of the ankle joint by replacing the unhealthy spots with healthy, smooth cartilage. Much of this bone is covered with cartilage. How much will this procedure hurt?This procedure can cause some discomfort. You should not have MP if the size of the OLT is too large for this technique, there is infection of the ankle joint or underlying bone, or your ankle is unstable. An osteochondral lesion can be a painful problem. It is kind of like having a pothole in the joint surface. Where will the healthy cartilage transplant come from?There are two sources of graft. This procedure may be performed with general or regional anesthesia. It may require multiple plugs to fill the gaps in the ankle surface. The blood supply to the talus is not as rich as many other bones in the body, and as a result injuries to the talus sometime… All surgeries come with possible complications, including the risks associated with anesthesia, infection, damage to nerves and blood vessels, and bleeding or blood clots. The content is not intended to substitute A bandage is placed around the incision sites. Preventing osteochondral lesions means avoiding traumatic ankle … OCD is a type of osteochondrosis in which a lesion has formed within the cartilage layer itself, giving rise to secondary inflammation. All rights reserved. If you need medical advice, use the "Find a Surgeon" search to locate a foot and ankle orthopaedic surgeon in your area. Osteochondral lesions of the talus (OLT) are ankle joint injuries involving damage to the joint surface (cartilage) and/or underlying ankle bone (talus). The orthopaedic surgeon makes incisions on the ankle to access the injured area. Pain medication as needed every 6 hours. The risk of infection and poor healing are much higher for patients who have uncontrolled diabetes or those who smoke. Surgery also might be considered if an OLT completely detaches from the ankle bone and/or begins to move around in the joint space, causing locking and catching. The tibia and fibula bones sit above and to the sides of the talus, forming the ankle joint. It is recommended that you avoid bearing weight … The defects cause deep ankle pain associated with weight… Once the procedure is finished, the surgeon closes the openings with stitches. Drilling into the lesion to create pathways for new blood vessels to nourish the affected area. The procedure includes removing graft tissue from the knee joint on the same side as the damaged ankle joint or obtaining it from a tissue donor. The medial facets of the talar dome articulate with the medial malleol… Young patients with a skeleton that is not yet mature typically do not have this surgery, nor should elderly patients with medical problems that would complicate recovery. Osteochondritis dissecans (OCD) of the ankle is the end result of the aseptic separation of an osteochondral fragment of the talar dome with the gradual fragmentation of the articular surface. The content of FootCareMD, including text, images, and graphics, is for informational purposes only. Which joints are most commonly affected by OCD? Amniotic cell therapy contains growth factors and stem cells which have shown to accelerate healing. MP might be considered if you continue to have symptoms after non-surgical treatment. Top. Figure 2 MRI view of an OCD lesion of the knee. Please click here to learn more about OCD of the Talus (Ankle… Posterior Tibial Tendon Dysfunction (PTTD). An osteochondral ankle defect is a lesion of the talar cartilage and subchondral bone mostly caused by a single or multiple traumatic events, leading to partial or complete detachment of the fragment. For osteochondritis dissecans (OCD) of the knee, avascular necrosis of subchondral bone can lead to fragmentation of bone and overlying cartilage [Figure 1]; osteochondral loose body formation may occur, leading to pain and further … This is known as an autograft. Many cases of ankle OCD are difficult to fully resolve and some will need more than one surgery. This minimally-invasive procedure is performed to stimulate the growth of fibrocartilage in an injured joint. “Osteo” means bone and “chondral” refers to … Surgery also might be considered if an OLT completely detaches from the ankle bone and/or begins to move around in the joint space, causing locking and catching. Recovery and surgery for an OCD lesion of the knee. After this, the patient can begin physical therapy to regain strength and motion of the ankle. Patients with other health problems may stay in the hospital for a longer period of time. 880 Seven Hills Drive, Suite 150 3,7,17,43,47 Treatments Ice is applied for 20-minute periods 3-4 times per day. Get Directions, (833) 693-3381 They may also be found in the talus bone in the ankle. Advanced arthritis throughout the ankle joint is another reason to avoid surgery. Your surgeon may perform retrograde drilling of the lesion, ankle arthroscopy of the ankle joint, osteochondral transplant autograft/allograft. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). The aproach can best be by anterior arthroscopy. info@laserfootsurgerycenters.com. The talus is the bottom bone of the ankle joint. Discussions with your surgeon should help figure out how to proceed if your previous surgery was not successful. Treatment is by debridement and bone marrow stimulation. May be due to micro trauma or a traumatic event. for professional medical advice, diagnoses or treatments. arthroscopic harvest of chondrocytes (from ankle or alternatively from knee) are sent for cultured growth; open approach via osteotomy for implantation; instrumentation debridement of lesion to create stable cartilage rim, subchondral bone exposed; bone graft may be placed if underlying cyst and bone loss This is called an allograft. Osteochondral lesion of the talus (OLT) is a broad term used to describe an injury or abnormality of the talar articular cartilage and adjacent bone. You should not have … Recovery: Average recovery time after undergoing surgery to repair an osteochondral lesion of the talus ranges from four to six weeks. There may be pain and swelling after surgery, but the swelling usually subsides after one to two weeks. 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