Osteochondral lesions of the talus are likely to occur along with an ankle sprain. In most cases, it is common if the injury occurs when landing on the ankle in which the tibia crushes the top part of the talus, thus damaging the covering cartilage.
The indications of osteochondral lesions of the talus usually includes ankle pain with swelling. The ankle might catch or lock and usually stiff. The ideal way to come up with a diagnosis requires various testing procedures such as MRI, bone scars or even surgery.
Osteochondral fractures associated with a sprain are not often detected initially. The sprain is treated and the ankle recuperates to an extent, but might continue to cause issues such as swelling and pain after activity. Large-sized fractures might be evident on X-rays. Other tests such as CT scans, MRI and isotopic bone scans are likely to detect the smaller osteochondral lesions.
Management of osteochondral lesions
- For grade I and II lesions, they are treated using conservative measures such as therapy and exercises.
- In the previous years, it has been recommended that the affected ankle is placed under a cast to immobilize it and promote healing but it is no longer advisable since joint movement without loading allows healing of the cartilage.
- Activities that involves weight bearing must be avoided and substituted with swimming or cycling to maintain fitness as well as keeping the ankle mobile.
- For grade I and II injuries that do not heal within 3 months, surgery might be required.
- For grade III and IV injuries, ankle arthroscopy is performed to get rid of the separated fragments.
- A rehabilitation program is started to help the individual regain ankle flexibility, strength and balance.