Osteochondral lesions are cartilage defects arising either from an injury or spontaneously in certain individuals. Symptoms are pain and stiffness of the ankle joint, mostly after activity ( running/ prolonged standing). It can occur in all age groups and is a common cause for a chronically painful ankle after an injury.

Anatomy
Osteochondral lesions occur on the talus bone mostly. Most of these lesions are thought to be caused by injury to the bone underneath the joint surface by a twisting injury. Some are actual chip type fractures, while others may result from injury to the bone’s blood supply causing an area of the bone to actually die.
 

Symptoms
Symptoms are pain and stiffness of the ankle joint, mostly after activity ( running/ prolonged standing).Sometimes there can be a catching/ locking mechanism.
 

Diagnosis
The history and physical examination may suggest the diagnosis of osteochondritis dissecans. X-rays of the ankle can reveal a defect on the talar dome but many cannot be seen on Xray. A CAT scan or MRI scan may be necessary to determine the full extent of the area involved.
 

Medical Treatment
Treatment depends on symptoms. If the problem is discovered immediately after a twisting injury to the ankle, then immobilization in a cast for 6 weeks may be suggested to see if the bone heals. If the problem is not associated with an acute injury, surgery may be required to try and reduce your symptoms, which involves removing the loose fragment of cartilage and bone from the ankle joint and placing small drill holes in the defect. The drill holes stimulate new blood vessels to fill the area and help to form scar tissue to fill the defect.