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Dr. Andrew Rynne

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MRI showed osteochondral lesion of the talus. Surgery required?

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Orthopaedic Surgeon
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My wife has a osteochondral lesion of the talus on her right foot diagnosed by MRI and tomography. She has a lot of pain daily and cannot do any sports. Long walks generate a lot of pain. She usually limps because of the pain.

She already did 2 anti-inflamatory infiltrations. The last one did not last 2 months, so we are done with paliative treatment.

What kind of surgery is available to give her back quality of life that would allow a normal lifestyle with sports and walking long distances?
Wed, 19 Dec 2012 in Bones, Muscles and Joints
 
 
Answered by Dr. Praveen Tayal 3 hours later
Hello,
Thanks for posting your query.
Osteochondritis dissecans of the talus s usually associated with a low level of chronic persistent pain, a variable amount of swelling which is often intermittent and not severe. A history of locking, catching or ankle sprains on multiple occasions is common.
In your wife's case, since the pain is not adequately relieved by conservative treatment, surgical options need to be considered.
Surgical method depends on the articular surface involvement and the stability of the area. Usually stabilization of loose fragments and replacement of defective tissue is done with either an autograft or allograft transfer osteochondral tissue.
Drilling the subchondral bone also helps in stimulating vascular ingrowth and subchondral bone healing.
Fixation of the lesions is needed. Bone grafting may be considered in unstable lesions with significant bone destruction.
Autogulous chondrocyte implantation, osteochondral autograft transplantation and osteochondral allograft transplantation may also be considered depending on the extent of the lesion. Most of these operative treatments are performed as an arthroscopic outpatient procedure. Often patients need to undergo a period of non-weight bearing with either cast or brace immobilization to promote healing for approximately 1-2 months after surgery.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
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