Osetochondritis dissecans (OCD) develops in your joints and affects adolescents and children mostly. It happens when a lack of blood supply causes a small piece of bone to separate from its neighboring area. This leads to the bone and the covering cartilage to loosen or crack.
Your ankle joint is made up of the top of the ankle (talus) bone and the bottom of the shin (tibia) bone. When you get an injury to the underlying bone of your talus and the cartilage within the ankle joint it is referred to as a talar dome lesion injury or an osteochondral defect (OCD).
Symptoms of Osteochondral Defect
It could take you years before you notice any symptoms of an osteochondral defect, unless your injury is severe.
Symptoms of OCD include:
- Chronic pain in your ankle that worsens when you bear weight on your foot.
- Occasional “catching” or “clicking” feeling in your ankle when you walk.
- Ankle swelling that occurs when you bear weight and subsides when you rest.
- Instances when your ankle appears to “lock” or “give out”.
Causes of Osteochondral Defect
An ankle sprain or similar injury is what usually causes osteochondral defects. After the injury, if your cartilage doesn't properly heal, it can soften and start to break off. In some cases, a piece of the broken bone and cartilage can 'float' in your ankle.
Diagnosis of OCD
It can be difficult to diagnose OCD since it can be hard for the doctor to pinpoint the exact area of your pain. He will question you about previous or recent injuries and give you an ankle and foot examination, moving your ankle joint to see if there is any clicking, pain or motion limitation in your joint. This will help the doctor come up with a diagnosis. He or she will take x-rays and often other advanced imaging tests such as an MRI to further evaluate the injury and determine its severity.
Treatment Options for Osteochondral Defect
The severity of your injury will determine what treatment you will receive.
Non-Surgical Treatment for Osteochondral Defect
If there are no loose pieces of bone or cartilage, your Pensacola orthopedic specialist might prescribe you one or more of the non-surgical treatment options below.
- Immobilization. The doctor might place your leg in a cast boot or cast to protect your talus. He might even recommend non-weight bearing range of motion type exercises during your immobilization period.
- Oral Medications. Ibuprofen or other NSAIDS (nonsteroidal anti-inflammatory drugs) can help reduce inflammation and pain.
- Physical Therapy. Strengthening and range-of-motion exercises can help once your injury has healed adequately and can reduce swelling and pain.
- Ankle Brace. Your doctor might have you wear an ankle brace to protect you from re-injury if your ankle is unstable.
Surgical Treatment for Osteochondral Defect
If your symptoms are not relieved with non-surgical treatment options, you might need surgery. Surgery might entail removing loose cartilage and bone fragments from your joint and promoting a healing environment. There are various surgical methods available and your orthopedic surgeon will determine and discuss with you the right one for your individual case. In either event, it is important that you set up an appointment with your doctor immediately after noticing any symptoms.
Frequently Asked Questions
Q: What is an Osteochondral defect?
These are central areas of articular damage involving damage to the cartilage and injury of the neighboring subchondral bone. Common OCD sites include the talus, femoral condyle, capitellum of the humerus and humeral head. This condition typically disrupts the underlying bone and cartilage. How disrupted may range from anything from a crater or deep defect to bruising on the joint surface.
Although you would think this condition would be similar to arthritis, it’s quite different. Joint surface changes are extremely localized whereas in arthritis it’s widespread. Changes are typically always on the talur side only and cause joint surface softening — arthritis is significant hardening.
The main symptom is pain and feelings of instability. Pain is usually felt most with bearing weight. However, you may experience pain while resting.
Q: What causes Osteochondral defect?
Typically, ankle sprains or injuries similar to these cause osteochondral defects (OCD). If your cartilage doesn't heal correctly after your injury, it may become soft and begin breaking off. Sometimes, a piece of broken cartilage or bone may get into your ankle.
There really isn't an exact cause of this defect. OCD is associated with pretty much anything that causes your cartilage or bones to come loose from one another. It's essential you monitor their development and growth, particularly in children, in case symptoms of OCD occur. Some osteochondral defect diagnosis cases can be worse than other cases.
Q: Is Osteochondral defect a fracture?
Osteochondral defects may also go by the name of osteochondral fractures. They are talus injuries involving both overlying cartilage and bone. Your talus is your ankle joint bottom bone. These injuries could include cyst-like lesions in the underlying cartilage bone, cartilage layer blistering or fracture of the bone layers or cartilage.
Q: What type of doctor treats Osteochondral defect?
You'll see an orthopedic doctor for an osteochondral defect. Treatment for OCD depends on your individual situation, including the location and size of the defect as well as your age. Some osteochondral defects require emergency attention by an orthopedic surgeon while others are more stable and may not require surgery.
Some treatments for OCD may include:
- Light exercise and physical therapy.
- Excision surgery for lesion area removal.
Before you receive any treatment, your doctor will recommend you rest from all physical activity. Keep the affected area free from stress which will help with the pain.
Q: Will Osteochondral defect heal itself?
If resting from physical activity and managing your OCD pain doesn't allow the defect to heal naturally, you will require treatment. Your treatment may involve either operative or nonoperative methods. Your treatment specifics depend on the presence of other injuries, the nature of your OCD and your characteristics.
Certain defects can heal with non-operative treatments and generally involves restricted weight bearing and immobilization. These methods may be followed by a slow progression of physical therapy and weight bearing activities. Non-operative treatment allows your injured bone and cartilage time to heal. Other defects may require surgery.