Osteochondral Injury of the Talus Treated by Mercy's Foot Surgeons

Foot and Ankle Reconstruction at Mercy - Baltimore

The surgeons at The Institute for Foot and Ankle Reconstruction at Mercy in Baltimore provide expertise in the diagnosis and treatment of osteochondral injuries. Patients rely on our foot and ankle specialists to provide advanced treatment options to help relieve the pain from ankle injuries such as an osteochondral injury of the talus.

About the Condition

The cartilage lining of the anklebone can be bruised when an ankle sprain occurs. As the anklebone (the talus) twists inside its box-like housing, the edge of the talus rubs up and hits the end of the tibia. This causes a bruise and leads to softening of the cartilage. It may lead to a small crack in the cartilage and a cyst forming in the talus bone. 

This is an osteochondral injury of the talus, or osteochondritis dissecans.

There are many grades of severity of an osteochondral injury to the talus. Minor events lead to bruising of the talus. If the injury is more severe, large pieces of bone and cartilage can break off and lie loose in the ankle joint.

NEXT: Symptoms & Diagnostic Process ›
Symptoms & Diagnostic Process

Symptoms of an osteochondral injury of the talus include:

  • Continuous pain
  • Swelling
  • Ankle instability
  • Immobility of the ankle

A foot and ankle specialist can diagnose an osteochondral injury of the talus by taking a medical history and conducting a physical exam. Often a CT scan or MRI may be needed to confirm the diagnosis.

NEXT: Treatment Options ›
Treatment Options

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.

Meet Our Doctors: Institute for Foot and Ankle Reconstruction
Institute for Foot and Ankle Reconstruction at Mercy - Baltimore, MD
Gary Pichney, DPM

Dr. Gary Pichney is a podiatrist specialized in advanced surgical techniques with expertise in forefoot, rear foot and ankle surgical reconstruction, sports medicine and amputation prevention in the diabetic foot.

Patient Story:
Foot and Ankle Reconstruction

Nurses tend to know doctors and this nurse knew just the right doctor to call when she ran into serious trouble with her foot.

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