Osteochondral Lesion

Ankle Pain and Deep Pain in the Ankle

What could be my problem?

This is a type of ankle injury to the talus bone, which is the bone at the bottom of the ankle joint, and usually involves both the talus bone and the overlying cartilage.  It may include bruising/contusion of the ankle cartilage layers, fracture of the ankle cartilage and bone layers, or cyst-like lesions within the ankle bone underlying the surrounding ankle cartilage.

What causes Osteochondal Lesion?

  • Traumatic injury to the ankle joint
  • Ankle sprains
  • Repeated trauma to the ankle joint

If I have deep ankle pain, when should I see a foot doctor?

  • Prolonged pain
  • Swelling
  • Locking or catching of the ankle: when the ankle freezes up and will not bend
  • Instability of the ankle joint

What are my treatment options?

Non-Surgical Treatment Options:

  • Immobilization of the foot and ankle: a hard or soft cast maybe necessary
  • Restricted weight bearing
  • Physical therapy
  • Corticosteroid: used after healing for post-traumatic inflammation
  • Anti-inflammatory medication
  • Pain medication, as needed

Surgical Treatment Options:

When conservative treatment fails, a surgical treatment may be recommended.  The goals of ankle surgery are to restore the normal shape and gliding surface of the talus to re-establish normal mechanics and joint forces.

Surgery may be done arthroscopically depending on the size or location of the lesion.  Treatments include debridement (removing injured cartilage and bone), fixation of the injured fragment, micro-fracture or drilling the lesion, and/or transfer or grafting of the ankle bone and/or cartilage.