Treatment depends on the severity of the osteochondral injury. The more severe types require surgery. If bruising of the bone is present, resting the ankle may be all that is required to alleviate the process. Most of the time, the initial injury to the talus is not recognized early enough and by the time the diagnosis is made, a cyst has formed in the talus itself. These cysts, or osteochondral defects, are invariably symptomatic and require treatment.
The treatment for an osteochondral defect of the talus is extremely varied and depends on the size of the defect and the extent of bone and cartilage loss. The simplest surgical treatment is arthroscopy. Multiple tiny punctures are made around the ankle. Through these punctures a small telescope is inserted and the inside of the joint becomes visible. Microscopic operative instruments are then inserted into the joint to clean out the cyst.
There are other, more extensive surgeries that occasionally need to be performed. These can range from bone grafting to more sophisticated treatments in which portions of the talus have to be replaced using large grafts. These grafts can be obtained from the patient’s own body or from a cadaver.
Recovery from these procedures depends upon the extent of the defect and whether it can be treated arthroscopically or through open means with grafting. If the defect in the talus is significant, the ankle may need to be fused to eliminate the pain.