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Best Ankle Osteochondral Lesions Treatment In Delhi NCR.

Ankle Osteochondral Lesions treatment at Arunalaya
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What is Ankle Osteochondral Lesions?

Ankle osteochondral lesions (OCLs), also known as osteochondritis dissecans (OCD) or osteochondral fractures of the talus, are injuries affecting the cartilage and underlying bone of the talus, the lower bone in the ankle joint. These lesions can range from minor cartilage damage to fractures involving both cartilage and bone.

Causes of Ankle Osteochondral Lesions

  • Trauma: The most common cause is an acute injury like a severe ankle sprain, often involving a twisting motion.

  • Repetitive micro-trauma: Over time, repetitive stress or minor injuries due to ankle instability or misalignment can also lead to OCLs.

  • Poor blood supply: The talus has a relatively limited blood supply, which can hinder healing after an injury and increase the risk of osteonecrosis (bone death) and OCL development.

  • Genetics and bone development: In some cases, abnormal bone development or a genetic predisposition might play a role.

Symptoms of Ankle Osteochondral Lesions

Symptoms can vary depending on the size and stability of the lesion, and they may not appear immediately after an injury. Common symptoms include:

  • Persistent ankle pain: Often described as deep pain that worsens with weight-bearing activities.
  • Swelling: Intermittent or persistent swelling around the ankle joint.
  • Clicking or popping: A sensation of the ankle clicking, popping, or grinding.
  • Locking or catching: The ankle may feel like it’s catching or locking during movement.
  • Instability: A feeling of the ankle giving way.
  • Limited range of motion: Difficulty moving the ankle fully.
  • Tenderness: Pain when pressing on specific areas of the ankle.
Diagnosis

Diagnosing an OCL typically involves:

  • Physical examination: A thorough assessment of the ankle, including checking for pain, swelling, range of motion, and stability.
  • X-rays: While X-rays can sometimes reveal bone abnormalities, they may not show cartilage damage.
  • MRI (Magnetic Resonance Imaging): This is the gold standard for diagnosing OCLs as it provides detailed images of both cartilage and bone, helping to determine the size, location, and stability of the lesion.
  • CT scan (Computed Tomography): A CT scan can be useful for evaluating the bony structures and any loose fragments.
Treatment

Treatment depends on factors such as the size and stability of the lesion, the patient’s activity level, and the presence of symptoms.

Non-Surgical Treatment

Non-surgical options are often considered for small, stable lesions and may include:

  • Rest and activity modification: Avoiding activities that aggravate the pain.
  • Immobilization: Using a cast or brace to reduce stress on the ankle and promote healing.
  • Pain medication: Non-steroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation.
  • Physical therapy: Exercises to strengthen the muscles around the ankle, improve range of motion, and enhance balance.
  • Steroid injections: Injections to reduce swelling and pain.

Surgical Treatment

Surgery may be necessary for larger, unstable, or symptomatic lesions that do not respond to non-surgical treatment. Common surgical procedures include

  • Ankle arthroscopy: A minimally invasive procedure where a small camera and instruments are inserted into the ankle joint to-
  • Debridement: Removing damaged cartilage and loose fragments.
  • Microfracture: Creating small holes in the underlying bone to stimulate new cartilage growth.
  • Fixation: Stabilizing loose fragments with pins or screws.
  • Osteochondral Autograft Transplantation (OATS) or Mosaicplasty: Transferring healthy cartilage and bone plugs from a less weight-bearing area of the patient’s own ankle to the damaged area.
  • Osteochondral Allograft Transplantation: Using donor cartilage and bone to replace the damaged tissue.

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