This allows us to treat the bone defect … Damage may also be the result of a direct blow to the knee. Other symptoms can include: These symptoms could include localized ankle pain, as well as discomfort on either the inside (medial talar OLT) or outside (anterolateral talar OLT) of the ankle. Those that fail to respond may be candidates for v… A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. The knee and the ankle joint are the most commonly involved joints for OCLs in the lower extremity. A history of trauma to the joint or prior joint surgery may be clues leading to an osteochondral lesion diagnosis. If pain and limited movement becomes severe enough that it’s presenting problems in daily life, speak to your doctor about a potential osteochondral defect diagnosis. A chondral defect refers to a focal area of damage to the articular cartilage (the cartilage that lines the end of the bones). The gold standard of operative treatment for lesions measuring <1.5 cm2 … The only difference is that with an osteochondral fracture, there may also be a bone fracture involved. For small-sized defects with intact cartilage, our treatment of choice is Retrograde Drilling of the lesion and filling it with a special bone cement. Pain and swelling are the most common symptoms of osteochondritis dissecans. With an MRI, the ligament structures, tendons and cartilage of the ankle can be examined and analyzed. The causes of osteochondral injuries are not yet completely understood, but some theories are lack of blood supply to the affected area, heredity, direct compressive trauma or repetitive strain. Osteochondral lesions (OCLs) are focal articular injuries of the subchondral bone and the cartilage with a multifaceted cause (trauma, ligament instability, ischemic necrosis, malalignment, endocrine diseases, and others). The diagnosis of cartilage damage (osteochondral lesion, also known as talar dome) is often done with x-rays and/or an MRI. The severity of the injury is best assessed using MRI. They can also occur from chronic, repetitive micro trauma. Treatment depends upon the size of the osteochondral defect and the condition of the overlying cartilage. They can start as bone bruising that develops into an osteochondral lesion. teristics will dictate the treatment required to obtain a satisfactory clinical result. Osteochondral injuries are … This injury is more common in adolescents and young adults and typically occurs at the knee, ankle or elbow. Presentation of patients with OLTs varies and depends on many factors, including the etiology and acuity of their lesion. Osteochondral defects in the knee are due to lesions of the cartilage and bone. Total loss of cartilage, leaves bones grinding together and often severe pain. An osteochondral defect refers to a focal area of damage that involves both the cartilage and a piece of underlying bone. Ther The past several “Treatment Dilemmas” columns have dealt with the treatment of chronic ankle pain subsequent to an ankle sprain (see page 92, July issue and page 88, September issue). Symptoms. Osteochondral defects and loose bodies are common causes of mechanical symptoms in the ankle. When a patient presents with pain, effusion, and mechanical symptoms with normal radiographs, further diagnostic workup is needed. The pain is usually worsened by activity. Osteochondral lesions are relatively common in children and adolescents, and the incidence is increasing. The most common symptoms associated with OLTs, including pain, swelling, and stiffness, are quite nonspecific. Patients who have osteochodral lesions typically will have pain in the involved joint. Osteochondral lesions of the talus are common and difficult problems to treat. They typically are associated with a history of trauma; however, nontraumatic etiologies have been described. Injuries can range from a fine crack of the joint surface all the way though to a piece of the bone breaking away. Osteochondritis dissecans usually affects the knee at the end of the thighbone (femur), ankle and elbow. An osteochondral defect of the talus is a lesion involving talar articular cartilage and subchondral bone. Prognosis of these lesions depends on stability, location, and size of the lesion.Imaging has an essential role in the diagnosis, staging, and management of osteochondral lesions. It usually occurs in the knee, ankle or elbow. They may also complain of mechanical symptoms, such as clicking and popping sounds caused by a loose fragment of cartilage and/or bone associated with the OLT. What symptoms might I have & should a defect always be treated? Osteochondritis dissecans (OCD) is a condition that develops in joints, most often in children and adolescents. It occurs when a small segment of bone begins to crack and separate from its surrounding region due to a lack of blood supply. However, if the lesion is large enough, or the overlying cartilage is displaced, talar OLTs can be quite symptomatic. The affected bone and its covering of cartilage may stay in place and not cause any symptoms, or a fragment may gradually loosen and cause pain. variable edema patterns, may overestimate degree of injury; unstable lesions show fluid deep to subchondral bone; sensitivity and specificity. Instability, locking, or catching can be other symptoms. A potentially fixable loose osteochondral body in the setting of a first-time PF dislocation or idiopathic OCD is an indication for early surgery (Figure 4). The presence of an osteochondral lesion may initially go undetected and may manifest many months after the initial ankle injury. These symptoms are often exacerbated by weightbearing. Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management.. stage I. injury limited to articular cartilage; MRI findings: subchondral edema; x-ray findings: none; stage II. In most cases an Osteochondral defect does not progress and deteriorate whereas as the opposite can be said of arthritis in many cases. Pain with weight bearing activities Chondral injuries may accompany an injury to a ligament, such as the anterior cruciate ligament. provides fine detail of lesions for pre-operative planning; MRI. An Osteochondral lesion is an injury to the articular cartilage and the bone beneath it. Symptoms of osteochondritis dissecans are a direct result of the irregularity of the cartilage within the affected joint. 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