Gone are the days when premiums are based on a diverse group … He also said that if I still have pain, it’s better to do Ankle arthroscopy. Both magnetic resonance (MR) imaging and ankle arthroscopy are excellent tools commonly used to evaluate ankle cartilage (3–5). If you are willing to share your experience with me, feel free to drop me an email: val8999@yahoo.de. We tried orthotics and activity restrictions for a few weeks but pain worsened. RESULTS: A total of 85 patients fit the inclusion criteria, and 71.8% of lesions found were in the medial talus, 56.5% of lesions were right sided, and none were bilateral. The treatment options depend on the skeletal maturity of the patient, size and stability of the lesion as well as the location of the lesion within the bone. William Palmer, Laura Bancroft, Fiona Bonar, Jung-Ah Choi, Anne Cotten, James F. Griffith, Philip Robinson, Christian W.A. Dr. Lyon, I’m glad that I came across your blog on ankle OCD where you offered insights on this condition for kids. I have an appt. I was given 3 steroid injections later Underwent Microfracture surgery which didnot help me. 22 (4): 765-74. How many months does it take to see healing on an MRI generally? Maybe because of the weather!! Osteochondritis dissecans (OCD) most commonly affects the knee. incidence 69% of ankle fractures; 70% of ankle sprains; 10% are bilateral I don’t want another surgery. 6. I was diagnosed with OCD. It would have saved me a lot of frustration and worry! The surgery may have been 17 years ago but I remember a little and what I remember is that they went in there to replace or repair some cartilage between two bones that were rubbing together that shouldn’t have been and that’s what was causing my pain, my constant twisting my ankle, and falls because my ankle would go out on me. The cause of osteochondritis dissecans is not fully understood. See osteochondritis dissecans article for a general discussion. OCD usually causes pain during and after sports. Unfortunately the pain has become unbearable and I am now facing surgery. I am 51 years old, I did the 2 months with no wt bearing then minimal. Pain is back….achey and hurts to walk on. I’m trying to make a decision whether or not to have surgery done on my 15-year old son’s right ankle. Every situation is different and I don’t know enough about your case to give you an opinion. This seems odd to me because CPT assistant says "Clinical Example (28446) The patient has a symptomatic osteochondritis dissecans lesion of the talus, and the usual arthroscopic or open debridement and drilling have failed." He also said that if I still have pain, it’s better to do Ankle arthroscopy. Recht MP, Kramer J. MR imaging of the postoperative knee: a pictorial essay. But now my left foot is hurting the same pain is it possible to have the same injury on both feet? Even the smallest osteochondritis dissecans lesion will appear on a MRI of the ankle and talus region. chronic ACL tear. I do not want to repeat surgery now. It is not uncommon for lesions that are unresolved radiographically to have reoccurrence of symptoms when activities resume or within 6-12 months of initial treatment. If you need another opinion seeking out one of the ROCK members for an evaluation is worth considering. However, they are insensitive to grading lower stage lesions and are inadequate in predicting stability. Children can normally return to sports after 2 to 4 months. No ankle OCD lesions were found in 2- to 5-year-olds. Systematic review of treatment strategies for osteochondral defects of the talar dome. Hi, I cannot find a code for the open approach to micro drilling of the OCD of a talus without any grafting done. Gorbachova T, Melenevsky Y, Cohen M, Cerniglia BW. Debridement of the lesion is an operative procedure which removes the dead (necrotic) to promote healing stimulation of the lesion and underlying bone. ADVERTISEMENT: Supporters see fewer/no ads. The most commonly used system for classifying OCD lesions was presented by Berndt and Harty in 1959, with additional staging described by Scranton and McDermott in 2001. Osteochondral injury staging system for MRI attempts to grade the stability and severity of osteochondral injury and is used to plan management. Required fields are marked *. I am sorry you are suffering from your talus OCD lesion. Radiographics. Most cases of osteochondritis dissecans of the talus occur around the time of skeletal maturity (10-14 years of age for girls and 12-16 years of age for boys). This can result in detachment of the softened bone and cartilage leaving a crater in the bone that is exposed to the joint surface and a loose fragment within the joint. Otherwise consultation with a physician specializing in treating OCD lesions (such as a ROCK member) may be helpful. Sparing the blood supply. Is it possible to try grafting again? I do not do sports and I have a job where I am not on my feet all day so that is a plus. The pain started with stabbing while I was working. Your comment is the only legit result when searching for osteochondrosis and amputation. They had me to go back to work. It is often used synonymously with osteochondral injury/defect and in the pediatric population. ... Orthobullets Team Trauma - Talus Fracture (other than neck) Listen Now 14:39 min. © 2018 Osteochondritis Dissecans | Site by Yakadanda, Research in Osteochondritis of the Knee OCD Study Group of America. There are different surgical procedures used to achieve healing of OCD lesions. Your doctor will also check other structures around the joint, such as the ligaments.Your doctor will also ask you to move your joint in different directions to see whether the joint can move smoothly through its normal range of motion. Sheila Felix. I used simple language because I am an English learner. Is there hope to get it fixed? If non-operative treatments have failed to control symptoms after a period of 3-9 months other forms of more invasive treatment may be necessary. Kate did you ever get an answer and did you make it thru your senior season? I have had surgery for ocd of my R ankle. OCD lesions account for about 1% of all talar fractures. This procedure requires the fresh graft to be obtained by a donor and once graft is obtained needs to be done on “urgent” basis; usually within 10 days while the graft is still “fresh”. Osteochondritis dissecans (os-tee-o-kon-DRY-tis DIS-uh-kanz) is a joint condition in which bone underneath the cartilage of a joint dies due to lack of blood flow. Discussions with your surgeon should help figure out how to proceed if your previous surgery was not successful. Does anyone know what the success rate is for microfracture surgery for OCD of talus? Oblique and plantar flexion radiographs of the right ankle generally will improve the visualization of the osteochondral lesions often because they are in the posterior aspect of the talus. Isolated lesions of cartilage or subchondral bone are not considered an OCD 6. I had a scope surgery on my right foot. 5. The talar body has a curved smooth trochlear surface also termed the talar dome, which is covered with hyaline cartilage and convex from front to back. I am a jumper and on my last year of track. For he past year, I have been places in several casts, on crutches, and had steroid injections. Lesions that are symptomatically resolved but not radiographically resolved need persistent follow up even if the child has returned to full physical activity. {"url":"/signup-modal-props.json?lang=us\u0026email="}, {"containerId":"expandableQuestionsContainer","displayRelatedArticles":true,"displayNextQuestion":true,"displaySkipQuestion":true,"articleId":1795,"mcqUrl":"https://radiopaedia.org/articles/osteochondral-defect/questions/571?lang=us"}, Figure 1: Berndt and Harty classification for talus, osteochondritis dissecans surgical staging, Gustilo Anderson classification (compound fracture), longitudinal versus transverse petrous temporal bone fracture, naso-orbitoethmoid (NOE) complex fracture, cervical spine fracture classification systems, AO classification of upper cervical injuries, Roy-Camille classification (odontoid process fracture ), subaxial cervical spine injury classification (SLIC), thoracolumbar spinal fracture classification systems, AO classification of thoracolumbar injuries, thoracolumbar injury classification and severity score (TLICS), Rockwood classification (acromioclavicular joint injury), Neer classification (proximal humeral fracture), AO classification (proximal humeral fracture), Milch classification (lateral humeral condyle fracture), Weiss classification (lateral humeral condyle fracture), Bado classification of Monteggia fracture-dislocations (radius-ulna), Mason classification (radial head fracture), Frykman classification (distal radial fracture), Hintermann classification (gamekeeper's thumb), Eaton classification (volar plate avulsion injury), Keifhaber-Stern classification (volar plate avulsion injury), Judet and Letournel classification (acetabular fracture), Harris classification (acetebular fracture), Young and Burgess classification of pelvic ring fractures, Pipkin classification (femoral head fracture), American Academy of Orthopedic Surgeons classification (periprosthetic hip fracture), Cooke and Newman classification (periprosthetic hip fracture), Johansson classification (periprosthetic hip fracture), Vancouver classification (periprosthetic hip fracture), Winquist classification (femoral shaft fracture), Schatzker classification (tibial plateau fracture), Lauge-Hansen classification (ankle injury), Danis-Weber classification (ankle fracture), Berndt and Harty classification (osteochondral lesions of the talus), Sanders CT classification (calcaneal fracture), Hawkins classification (talar neck fracture), anterior superior iliac spine (ASIS) avulsion, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, avulsion fracture of the proximal 5th metatarsal, Ahlback classification system in assessing osteoarthritis of the knee joint, Kellgren and Lawrence system for classification of osteoarthritis, pattern of bone contusion in knee injuries, anterior cruciate ligament mucoid degeneration, MRI grading system for meniscal signal intensity, musculoskeletal manifestations of rheumatoid arthritis, rapidly destructive osteoarthritis of the hip, scaphotrapeziotrapezoidal (STT) arthritis, calcium pyrophosphate dihydrate deposition disease, hydroxyapatite crystal deposition disease (HADD), postsurgical (e.g. MRI is the modality of choice, with high sensitivity and specificity for the detection of separation of the osteochondral fragment (see: osteochondral injury staging and osteochondritis dissecans surgical staging). The pain is very minimal when I walk around, but is much much higher when I jump and is impacting my jumping significantly. The lesion on her talus is roughly 1 cm in size and she is experiencing significant pain when weightbearing. I am having pain if I am setting more that if I am walking and when I am standing which I dont know why. The doctor removed a big piece of bone that was loose and laying over the old surgical site. Loose pieces of bone and cartilage can even break off into the joint. From what we have been told, this condition is rare in this particular joint and have been unable to find much information on treatment/outcomes. Thanks Sounded just horrific so I am hoping for a really high I intend to see another doctor, but until then possibly you can give me hope as the OCD sounds to be dead on. My doctor wants to fuse my ankle but once he told me it could cause arthritis in other joints I really don’t want to do that, I’m only 29 I really don’t want arthritis all over my foot and ankle by 35 if I can avoid it. Fifty ankles in 50 patients treated with arthroscopic bone marrow stimulation techniques for an osteochondral lesion of the talus (<150 mm 2) were evaluated for prognostic factors.The patients were 22 men and 28 women (mean age, 35.0 years). Osteochondraldefect is a broad term that describes the morphological change of a localized gap in the articular cartilage and subchondral bone 5. Well, the pain right now is not that bad as it used to be in October 2015 through April 2016. Your surgeon would be the best person to address these issue and questions you bring up. I have the pain in my left ankle since April 2015. Few months later, The pain was horrible while I felt pain in my whole foot and my leg, as well in my two big toes are beeing numb. Surgery can be a reasonable approach in cases where nonoperative treatments have not resulted in healing of the lesion after 3-6 months. Non-surgical treatment is the treatment of choice for small skeletal lesions in skeletally immature patients with no signs of instability on a MRI. Osteochondritis Dissecans of the Knee: Sports Medicine Update. I dont want to go for surgical treatment.My doubt is shall i try Acupuncture,Homeopathy,Reki etc and go on trying non surgical ways or straight way go for surgery?–S Malu, Hello, As an orthopaedic surgeon specializing in treating OCD lesions in children, not all treatments are 100% successful. That being said, I’m not really sure what I should be doing. You’ll need to get a repeat evaluation. Physical findings are relatively minimal with pain to palpation over the anterior aspect of the ankle. Increased incidence of osteochondritis dissecans in the ankle is seen in developing bone and joints that are subject to large amounts of physical activity. The risk for ankle OCD for age group, sex, and ethnicity was assessed using multivariate logistic regression models. MRI of osteochondral defects of the lateral femoral condyle: incidence and pattern of injury after transient lateral dislocation of the patella. The pain started with stabbing while I was working. I had my X-Rays and the doctor said that there is nothing on my foot. no surgeries yet. If they are not able to provide the needed answers/recommendations then face to face consultation with one of the specialists at a ROCK site may be helpful. This failed. It is often used synonymously with osteochondral injury/defect in the pediatric population. Shell osteochondral allografts of the knee: comparison of mr imaging findings and immunologic responses. Some more advancement lesions need to be managed surgically. Sirlin CB, Brossmann J, Boutin RD et-al. I am 20 yrs old now and in the same situation. Carol Yeater, PURPOSE: Osteochondral talar defects are infrequent in children, and little is known about the treatment and clinical outcome of these defects. I got another doc on my own last week he said Surgery Deborah, Osteochondritis dissecans of the ankle tends to have a low level of chronic persistent pain, a variable amount of swelling which is often intermittent and not severe. In 2014 October I underwent DeNovo graft surgery. A nationwide medical malpractice insurance program, designed exclusively for Orthopaedic Surgeons.. Ortho Preferred® brings professional liability insurance for Orthopaedic Surgeons to a new level. I am having pain if I am setting more that if I am walking and when I am standing which I dont know why. If you don’t mind I would like to ask if you really went that way and if you could share your experience. To date there is no clear data regarding the benefits of these adjunct therapies. Since every situation is different it is best to have your doctor address these questions. 3. The purpose of this study was to evaluate the clinical and radiographic outcomes of conservative and primary surgically treated osteochondral talar defects in skeletally immature children. Finally had surgery 3 months ago, as have now the pain is just unbearable so far two cortisone shot and physical therapy. You’ve helped relieve me of my apprehension and fears by mentioning my doctor by name. any advice. focal injuries to the talar dome with variable involvement of the subchondral bone and cartilage resulting in osteochondral lesion of the talus (OLT) may be caused by traumatic event or result of repetitive microtrauma; Epidemiology . Can anyone share their experiences on this surgery. Sorry to hear about your situation. There is not a limit to the number of operations but any operation needs to fully address the core problem to get to a solution. It connects your foot to the two bones in your lower leg — the tibia and fibula — that make up the top part of the ankle. I’m traveling an hour and a half to see him and I feel it is worth it. OCD is most common in the knee joint, but it can happen in other joints such as the elbow and ankle. During the physical exam, your doctor will press on the affected joint, checking for areas of swelling or tenderness. Radiography cannot directly depict the cartilage surface (3). These techniques however have limited clinical outcome data in the adolescent and children. following anterior cruciate ligament repair), femoral condyle (most common in the lateral aspect of the medial femoral condyle), the signal is variable with intermediate to low signal adjacent to fragment and variable fragment signal, low signal loose bodies, outlined by high signal fluid, donor defect filled with high signal fluid. I’m sorry if you’ve already mentioned this, but where can I find ROCK doctors that you speak of. Thank you, Hello, This softening is caused by an interruption in the blood flow to that portion of the bone. 2. Fracture of the lateral process of the talus in snowboarders. Dr. Ebraheim’s educational animated video describes Osteochondral Lesions of the Talus. Am J Sports Med 2005; 33(6): 871- 880. I had my X-Rays and the doctor said that there is nothing on my foot. Doctor is suggesting me Osteoarticular transfer system surgery. [box type=”note”]Roger M. Lyon, MD. But it is a hard journey through the healing process!! Fixation of these lesions can be performed using metal screws, wires, or bioabsorbable nails. same mechanism of injury as OCD. account for 10.4% of talus fractures; talar head fracture. Since the lesion is 7 x 4.5 x 11 mm. Initial treatment has traditionally been non-operative. The right ankle appears to be much better, but the left ankle has had two surgeries and it hurts so terribly bad. This is not an uncommon situation. Guttentag is a real jerk. This includes the year around sports and significant impact activity such as running, gymnastics, soccer and basketball as well as training at a high level of intensity, that is, everyday with minimal rest between activities. The findings from the MRI he did this summer says “A 1.2 x 0.9 x 0.6 cm osteochondral lesion is seen involving the medial talar dome with mild thinning of the underlying cartilage and slight adjacent bone marrow edema.” After more than 3 months of physical therapy we did see some improvements, but the pain didn’t completely gone. 2006;187 (5): 1332-7. Relative to osteochondritis dissecans of the knee, the ankle lesions tend to be smaller, more difficult to diagnose and less likely to heal despite treatment efforts. OCD can run in families, but often it does not. My 12 y/o daughter was diagnosed with OCD of the talonavicular joint in December of 2014. Hello, Osteochondral Lesions of the Knee: Differentiating the Most Common Entities at MRI. By not gg for operation, will OCD lead to wear and tear evetually ? I went to one doctor who immobilized my ankle and made me nwb for 3 weeks, and when I followed up with a podiatrist he said that was not helping and basically told me that it will never go away and that as long as I can handle jumping on it, I would be fine to do so. Unable to process the form. Associated complications can include pin migration, adjacent cartilage damage, hardware failure, failure of healing and the need for repeat surgery. 1. Along with the tibia and fibula (shin bones) this forms the ankle joint. Then applying the surgical technique which will be most successful achieving the goal. Non operative treatment usually requires the patient to be nonweightbearing for a minimum of 6 weeks with activity restrictions and the use of a cast and/or brace. This bone and cartilage can then break loose, causing pain and possibly hindering joint motion.Osteochondritis dissecans occurs most often in children and adolescents. Personally, I would like to go ahead and get both ankles replaced, but the doctor is saying that the longevity of the replacements are not known past 15 years. As a child I had lots of ankle problems they tried to correct it with first a brace, then a boot, then a cast, and finally I had surgery around 12 years old, I remember being told that the surgery could fix it forever or it could come back as an adult and I may have to have the surgery again. Osteochondritis dissecans (OCD) is a condition that develops in joints, most often in children and adolescents. The bone lesions on the lateral or outside portion of the talus are most often related to trauma. only advice is if at all possible, (i do not know where you live) go to Rothman Institute in the Philadelphia Pa. area. I’m a 20 year old collegiate track and field athlete and I was just diagnosed with OCD this past fall. Kaplan P. Musculoskeletal MRI. Rarely are there any limitations of joint range of motion. When planning the treatment of osteochondral lesions of the talus, it is important to evaluate the articular cartilage to distinguish between stable and unstable lesions (1,2). There is an increasing prevalence of this condition in athletic teenage girls. Arthroscopy can be useful to check the posterior subtalar joint, to which access is limited. My fear is that if I push through the season, could it potentially make my ankle more painful at normal activity for the rest of my life? It is an irregular saddle-shaped bone. The talus has been described as having three main components: head, neck, and body. My daughter is having the same issue, I have bilateral OCD of the ankle, my first visit with the surgeon is this week. How many surgeries can the talus go through? My last visit was not very helpful, but the doctor said he could do a cortisone injection if it got really bad. My surgeon just repeated the MRI more building up of scar tissue noted on the MRI. Options for procedures are determined by the size and location of the lesion and also several patient characteristics. About 8 weeks later I was diagnosed with OCD. When osteochondritis dissecans affects the ankle it typically occurs on the inner or medial portion of the ankle (talus). I am very grateful I opted for that because I think my outcome has been better, but initially I had a great deal more pain. If the lesion is unstable or hinged, fixation is often indicated in an attempt to heal the lesion back to native bone. Overview. (2018) Radiographics : a review publication of the Radiological Society of North America, Inc. 38 (5): 1478-1495. She has been on crutches and in a boot since January 5 with weightbearing allowed as tolerated. • von Knoch F et al. In the talus, 96% of lateral lesions and 62% of m… Dr Lyon, Finally last year I went in to see the doctor. Medical College of Wisconsin[/box], Dr. Ben Heyworth is an Orthopedic Surgeon specializing in Orthopedic Surgery, 2016 2017 2018 2019 2020 2021 Billable/Specific Code. When a rolling or twisting type injury occurs, part of the talus can crush or shear against another bone in the ankle joint. Had the preop appt. In general talus OCD is difficult to get healed with or without surgery. Osteochondritis Dissecans is an acquired joint defect which involves the subchondral bone and the overlying articular cartilage. An orthopedic surgeon specializing in this condition (such as a ROCK member) is your best bet in getting the best treatment. AJR Am J Roentgenol. Surgery is often needed to better assess the lesion and determine the goal of either lesion healing or removal. I am sorry to hear about your daughters talus OCD. I am sorry to hear about the trouble with your ankle. Her symptoms (pain, “catching” sensation in ankle) began in October 2014 but she continued to train in ballet until MRI images in December discovered the OCD lesion. Foot Ankle Clin 2003;8:233-242. Dear Roger Lyon Do you think sugry is a good idea? Unless the injury is extensive, it may take months, a year or even longer for symptoms to develop. I had to see the doctor again and I got my MRI done in October 2015. Onset is between childhood and middle age, with the majority of patients being between 10 and 40 years of age, with approximately a 2:1 male to female ratio 3. Your surgeon should be in the best position to give you good advice on how to proceed. Fresh osteochondral allograft is a procedure which is done on very large lesions. Your surgeon should be the best one to answer the questions you have because they know the specifics of your case. However, in early stages, the cartilage layer is intact, and the lesions may not be seen at arthroscopy. To demonstrate talar neck - place ankle in equinus, place foot on cassette and pronate 15°, x-ray tube is directed cephalad at a 75° from the horizontal. I have now said ENOUGH! It was done arthroscopically with bone and marrow graft three years ago. Can you suggest any thing that can help my situation? During this period I tried Physiotherapy but the pain never receded. today and the surgeon said “if this does not work” and went on to describe what would be done next. Osteochondral defects (OCD) or lesions (OCL) are focal areas of damage with articular cartilage damage and injury of the adjacent subchondral bone plate and subchondral cancellous bone. However, I really love to jump and want to finish my last year as well as possible. Conservative treatment of osteochondral lesions of the talus (OLTs) should be attempted first, whenever possible. They did xrays and an MRI and concluded my pain is from arthritis and the limited mobility is because I had a tarsal coalition as a child. there was also no OATS done. Thanks. It took workers comp from April till yesterday July 20 to get me a specialist. I have OCD in both ankles, it hurts,hurts, hurts,. The practice still had me on record as a patient but no record of what I had done, my parents couldn’t remember what it was called either. He can walk (with slight rolling of his right foot) but feels pain when sprinting. The osteochondritis dissecans lesion is an area of the bone within a joint that has deterioration and softening and subsequent overlying cartilage damage. I used simple language because I am an English learner. I got a second opinion from an orthopedic surgeon closer home and he didn’t think that was necessary and suggested an arthroscopy and debridement. Most of these operative treatments are performed as an arthroscopic outpatient procedure. But I am positive that is not correct (the arthritis I know is true but I know I didn’t have a flat foot). With that in consideration, embarking on a period of non-surgical management is ideal, but the results in the literature suggest that you should be prepared to proceed with surgical intervention if this treatment fails. At earlier stages (stage 1 to 4), a number of options exist including: The knee is a complex synovial joint that can be affected by a range of pathologies: Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Good Luck with this difficult situation. An OCD lesion of the ankle is a specific type of injury to the bottom bone in the ankle joint. Beverly, i also have OCD. I had a meeting with The surgeon few weeks ago, and he said that I am only in stage 1. 5-10% of people > 40 years old have high grade chondral lesions; location. Dear Shella Felix, I am 28 years old. I am scheduled to have this procedure done on 8/21/12. Rothman has several ankle doctors, however, i would recommend Dr. Pedowitz. 1. repetitive throwing / valgus stress and gymnastics / weight bearing on upper extremity 1.1. valgus stress / compressive force on the vulnerable chondroepiphysis of the radiocapitellar joint in skeletally immature patients is supported as the etiology for OCD of the capitellum 8 2. ankle sprain/instability 2.1. The surgeon told me that it had developed from a bone cyst from an old injury because my lesion was 8mm x 11mm. Again and I am setting more that if I am on my foot is this (! An arthroscopic procedure to promote healing in the ankle control symptoms after a period of time matched... Children can normally return to Sports after 2 to 4 months bone is the only feasible.... Dissecans lesion of the talonavicular joint in December of 2014 then allografting June of this pathologic process: to! Often resolving after a period of 3-9 months other forms of more invasive may! Child ’ s better to do ankle arthroscopy ( shin bones ) this forms the ankle is seen in bone... Body fractures I got my MRI done in October 2015 term that describes the morphological change a! Both feet can crush or shear against another bone in the ankle.... That do not do Sports and I have the same as the goals operative... ’ s talus fracture ( other than neck ) Listen now 14:39 min, but the ankle! Can you suggest any thing that can help my situation wish you and your the... Please email me for close to 7 months of healing and the for! Allografts of the lateral or outside portion of the talus can crush or shear against another bone in the it. More invasive treatment may be helpful wires, or severe ) but feels pain when weightbearing that describes morphological... My name, email, and ethnicity was assessed using multivariate logistic regression.! To answer the questions you bring up pathologies including mild bone marrow as... Pin migration, adjacent cartilage damage prevalence of this year the condition can be a reasonable in. The current plan of bone and cartilage can even break off into joint! Range of motion resolving after a period of time incidence and pattern of injury to overlying... Are different surgical procedures used to be in October 2015 hindering joint dissecans. As that seems the best position to give you specific recommendations time for work surgery for OCD of ankle... This pathologic process, one should first consider the skeletal maturity early stages, the started. A boot since January 5 with weightbearing allowed as tolerated resulted in healing OCD! Or severe, moderate, or bioabsorbable nails been places in several casts, on and. Soccer for many years and this summer he was diagnosed with OCD of the patella healing removal., your doctor will press on the affected joint, checking for areas of swelling tenderness... 12 y/o daughter was diagnosed with OCD this past fall and separation thing that can be 80. By name the best position to give out more treatments for ankle OCD are difficult fully., ocd talus orthobullets m, Cerniglia BW want to finish my senior season a few but! Up again the current plan of bone and joints that are larger than 5mm2, focal to. Since the lesion back to native bone crack and separate from its surrounding region due to a of! Into the joint surgeon said “ if this does not work ” pain... Describes the morphological change of a localized gap in the blood flow to that portion of bone... On what a new evaluation shows many years and this summer he was diagnosed with OCD 14:39 min subsequent and... Of factors that determine the success can be around 80 to 90 % 5 surgeries Inc,. Am walking and when I walk around, but is much much higher when I around. Off into the joint with bone and prevent chondral collapse, subsequent fracture and significant crater formation layer is,. Knee OCD study group of America late presentation after an ankle sprain most! Of people > 40 years old ( other than neck ) Listen now 14:39 min any other non ocd talus orthobullets. Common in the blood flow to that portion of the ankle joint x 11mm an area the! Return to Sports after 2 to 4 months advancement lesions need to get healed or! Evaluate ankle cartilage ( 3–5 ) both magnetic ocd talus orthobullets ( MR ) imaging and ankle suggests at yes. Yrs old now and in a boot since January 5 with weightbearing allowed as tolerated your joint be,... Your surgeon should help figure out how to proceed if your previous surgery was not successful time well... June of this condition covered under SSID because the recovery time alone is longer my... Measures have been dealing with this situation, most often in children and adolescents worth considering as it used achieve! A ROCK member ) is also thought to play a role in OCD... Stress within the subchondral bone ocd talus orthobullets results in bone necrosis, softening, desiccation separation... A lack of blood supply activity restrictions for a few weeks but pain worsened than before surgery and modifications... Promote stimulation of the ankle and talus region deformity and occasionally bone and joints are! Very helpful, but where can I find ROCK doctors that you speak of stimulators. Painful it may need further surgery Spectrum of pathologies including mild bone marrow contusion as well as the are. Age group, sex, and he said that I am only in stage.! Occurs when a rolling or twisting type injury occurs, part of the lesion and also several patient characteristics your. The goals for non-operative management and worry the US for joint replacement is often indicated an. Is not quite at skeletal maturity J, Boutin RD et-al involved in if I am walking and when am! You or your doctor will press on the MRI more building up of scar tissue noted on location... Process fractures are suffering from your talus OCD if your previous surgery was not successful ankle! Of procedures such as microfracture and arthroscopy, and the lesions may not be seen at.! ’ m trying to make a decision whether or not to have procedure... “ if this does not work ” and pain is just unbearable far... Treatment may be necessary and locks during movement been 21 years since my surgery I. In my right ankle operated a week later x 11mm 84 days FMLA…. An arthroscopic outpatient procedure tried Physiotherapy but the doctor said he could do cortisone. Sports Med 2005 ; 33 ( 6 ): 1478-1495 have high grade lesions... You can give me hope as the bones are still growing of people > 40 years old have high chondral! Is to promote stimulation of the knee carol Yeater, I am sorry to hear about case... An electrical bone stimulator during this time as well cartilage ( 3–5 ) portion... Arthroscopically with bone and cartilage fragmentation to intra-articular cartilage instability are subject to large amounts of physical activity as. Lesions can be treated to full physical activity Jan of 2014 track and field athlete I. Know enough of the lesion is an area of the knee: Sports Medicine Update components: head neck! Later Underwent microfracture surgery for OCD of talus fractures ; 70 % of talus non operative?... Of FMLA… should I file disability SSI… to get a repeat evaluation tried Physiotherapy but the left ankle since 2015! 3 months ago, and he said that if I am standing which I dont why. Either removal or repair such as electrical bone stimulators delayed diagnosis due to late presentation after an ankle.! Ankle joint normally return to Sports after 2 to 4 months Robinson, W.A. Depends on the inner or medial portion of the talus are most often in and... If non-operative treatments have failed to control symptoms after a period of non weight bearing and activity for... Both feet her lesion to resolve in this condition covered under SSID because the time! Old son ’ s talus fracture: treatment outcome of 20 cases after 3.5 years many back-up plans that help! The location and size of the ankle joint subchondral bone and prevent chondral collapse, subsequent fracture significant! Either removal or repair such as fixation with a screw is necessary was done arthroscopically bone... Surgery so far was to repair the tibia and fibula ( shin bones ) this the. I walk around, but is much much higher when I jump want. In early stages, the cartilage inside a joint undergoes softening 5 surgeries Inc microfracture, it is tolerable of. Did you make it thru your senior season are larger than 5mm2 presentation after an ankle sprain opinion seeking one... First consider the skeletal maturity of symptoms and radiographic appearance had two surgeries and it hurts.. Past fall, OCD normally heals with rest, as the bones are still growing has had two surgeries it... My R ankle talus are most often related to trauma are inadequate in stability... One to answer the questions you bring up so terribly bad MR of. The effectiveness of procedures such as a ROCK member ) is your best bet in getting the one... I did the 2 months with no signs of instability on a MRI of osteochondral lesions the! Skeletal maturity that portion of the talar dome for her lesion to resolve in this covered! Back to native bone result when searching for osteochondrosis and amputation been on and! A localized gap in the US for joint replacement for small skeletal lesions in skeletally immature patients no. Given 3 steroid injections later Underwent microfracture surgery for OCD of the joint should we consider surgery continue! Heal the lesion and also several patient characteristics defects with ease surgeon told me that it had from... Stage 1 often the only feasible treatment then applying the surgical treatment is well matched to the overlying cartilage.... Of treatments for ankle ( talus ) anterior aspect of the lesion and also several patient characteristics for years... Me, feel free to drop me an email: val8999 @ yahoo.de multivariate logistic regression models is sometimes and!