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Intermittent ankle pain. Active in sports. Advised arthroscopic surgery. Risks of not getting surgery done?

My 13 year old boy has been complaining of ankle pain off and on for at least 2 years. The pain was so intermittent that it was difficult to tell what was truly ailing him. It wasn t like the minute he came home from a practice that he was complaining that his ankle hurt. He is very active in sports - football, basketball, baseball, wrestling. We resorted to requiring all high top shoes for sports, he uses an OTC brace or sock to help when the ankle is bothering him. Finally this past August we took him to an Orthopaedic surgeon . He x-rayed it in his office but the xray was a bit inconclusive. We decided to see if we had any improvement and if not move forward with an MRI . He has been complaining more the last few months - always wearing the extra support and a few times the ankle gave out while walking up and down the stairs. He has aslo had a very loud clicking every step that he walks up - when going upstairs. A few days ago his foot started hurting again. So we went forward with an MRI. Was told that it is an Osteochondral Lesion that evidence shows on MRI it is not from a new injury but something perhaps recurring multiple times (also stated by the radiologist who read the MRI). Dr s recommendations were 1. Immobilize 6 to 8 weeks -- or 2. Arthoscopic surgery to get in there and try to put some holes to encourage the growth of new cartlidge. The Dr said his recommendation would be the surgery due to this being an older injury. What are the risks of not having surgery? I keep seeing that immobiliziation and/or anti-inflammatories may help - but I can t understand how that will heal the issue my son is experiencing (intermittent pain and of course the clicking noise). If the cartlidge growth is recommended isn t it an indication that it is past the immobilization stage --- it will always be there ---? What kind of damage if we delay? Can it get worse as time goes on if not treated? I.e. are we delaying the inevitable. This is a very active child.
Asked On : Mon, 11 Mar 2013
Answers:  2 Views:  69
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Orthopaedic Surgeon, Joint Replacement 's  Response
Jul 2013
Hi, thanks for writing to HCM.

I understand your concern for the young boy.

But the fact is, these osteochondral lesions tend to become more widespread with further load bearing impact activities like playing any form of sport. So it will definitely gets worse with time.

The earlier the intervention ,better the results and outcome.

If you happen to neglect it now, over a period of time it may lead to degenerative arthritic changes in the ankle joint which is a more serious trouble.

So, I suggest you to follow the advice given by the orthopedic surgeon and hope for the best.

Hope this information is helpful. Good luck

Answered: Tue, 6 Aug 2013
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