Initial x-rays are taken to check the alignment of the foot and ankle, as well as look for any bone damage. With an MRI, the ligament structures, tendons and cartilage of the ankle can be examined and analyzed. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. One study reported a 53% poor clinical outcome with microfracture for cystic lesions, while 2 other studies found no significant difference in outcome scores between patients with cystic or noncystic lesions. Recovery timeline You could be a cast for eight weeks after surgery. Any at home exercises any of you can give me to help me be able to put any weight on this foot would be greatly appreciated. If you have had an osteochondral lesion to the talar dome and following any appropriate rehabilitation you are still experiencing issues with either, pain, stiffness and/or walking then visit Chiropody.co.uk. Best of luck. It appears you have not yet Signed Up with our community. Hi , I also have an osteochondral lesion with cystic change. Stage 3 • Nondisplaced lesion with lucency: Stage 4 • Displaced fragment Hangody L: The mosaicplasty technique for osteochondral lesions of the talus. When the cartilage and the talus below become injured, this causes an osteochondral lesion – meaning a lesion affecting both bone and cartilage. Stay healthy through tips curated by our health experts. suggested internal fixation of the lesion if it is larger than one third of the size of talar dome while Stone et al. In either case, the Drill Tip Guide Pin is advanced to a depth of 15 – 20 mm. There was a problem adding your email Patients can have three different kinds of complaints, whether or not in combination: 1. Mine is on the inside, and I was told its easier to get to the outside for repair. I also, like Kim, had drilling first that failed. I am leaning toward the microfracture but have been told by one ortho doctor it won't work because my defect is to extensive. Most treatments require a period of immobilization and restricted weightbearingthat can range from several weeks to several months. Ask our community of thousands of members your health questions, and learn from others experiences. At that point I didn't know there was an injury - just thought my body was a bit odd! The talar dome is a trapezoid-shaped protuberance of the talus, 2.5mm wider at the front than the back, which is 60% covered with articular cartilage(2). The talar dome has no direct muscle attachments(2); during norm… My most recent MRI indicated the lesion is now 8x8mm. • Cystic lesion within dome of talus with an intact roof on all view: Stage 2a • Cystic lesion communication to talar dome surface: Stage 2b • Open articular surface lesion with the overlying nondisplaced fragment. [QUOTE=PatriciaBeet;3776287]Hi Everyone... Stay healthy through tips curated by our health experts. All rights reserved. Is the surgery you are considering microfracture , where they go in thru tiny incisions and drill around the lesion? Let me know what other things I can do. mechanism of injury that causes talar dome fractures. I am (was?!) I'm 35.5 years old now. Recovery time after an osteochondral lesion depends on the nature of the lesion and the treatment approach. Nelson SC, Haycock DM: Arthroscopy-assisted retrograde drilling of osteochondral lesions of the talar dome. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). There was a problem adding your email Ask our community of thousands of members your health questions, and learn from others experiences. Talar dome lesions are usually caused by … I had ligament issues and tendon issues to go along with my mess. I've had it for around 20 years but only just diagnosed. I know it's too soon to be sure, but I am at least over the pain and am hopeful that the problem is solved. I appreciate your input and I definitely will let my dr. know if I start feeling any kind of pain in the ankle or start hearing that "clicking" again when flexing the foot. When the cartilage is damaged, or when a fracture to the talar dome occurs this is called an osteochondral lesion of the talar dome. It is recommended that you avoid bearing weight until your ankle has healed. This condition is also known as either osteochondritis dissecans (OCD) of the talus or as a talar osteochondral lesion (OCL). The outside and top part of the lower bone of the ankle (the antero-lateral talar dome) Clinical Presentation. Hi I have a large shallow Grade III Osteochondral Lesion of the Talar Dome. I'm 35.5 years old now. This time I'm going to try and take things slower. I also have a lesion on the medial side of my talus. Patients with this condition usually make a full recovery with appropriate management (whether surgical or conservative). “Osteo” means bone and “chondral” refers to cartilage. I did push my recovery way to much last time around. It appears you have not yet Signed Up with our community. 4. Osteochondritis dissecans (OCD or OD) is a joint disorder primarily of the subchondral bone in which cracks form in the articular cartilage and the underlying subchondral bone. Talar Osteolytic Lesion as the Initial Presentation of Terminal Primary Metastatic Adenocarcinoma: A Case Report November 2020 The Journal of Foot and Ankle Surgery “Osteo” means bone and “chondral” refers to cartilage. They may be fitted with a boot and begin physical therapy after 4 weeks, and expect to bear weight around 6 weeks. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. I was able to manage it conservatively by orthotics, not running, etc but have had ongoing problems since I … Another doc wanted to perform an oats procedure where they take cartilage frkm the knee and plug the hole from the defect. The surgeon agreed that it was time to do the surgery and that if I didn't have it done, even with the 60-70% success rate of the surgery, I could be a candidate for ankle replacement in the future. I never felt this kind of pain before. Is your defect on the mediAl or lateral side of the ankle? A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Surgery usually involves removing the loose fragment of cartilage and bone from the ankle joint and drilling small holes in the injured bone. Surgery may be required to try to reduce your symptoms at this point. I did manage to get around using a knee scooter (Roll A Bout) and found out they manufacture them right near my town..was very reasonable to rent...and much better than crutches. Hi I have a large shallow Grade III Osteochondral Lesion of the Talar Dome. It’s also known as the Brostrom procedure. If it is on the shoulder of the talus, it is drilled at a 45° angle. OCD usually causes pain during and after sports. recommended fixation of the lesion larger than 7.5 mm . Do not copy or redistribute in any form! The patient presented with a history of a medial talar dome osteochondral lesion (OCL) for over five years prior to her first microfracture surgery in 2008. More involved procedures that include bone grafting or cartilage transfer may require a longer period of recovery. I've had it for around 20 years but only just diagnosed. DeLee et al. Unless the injury is extensive, it may take months, a year or even longer for symptoms to develop. Either way it's at least six weeks non weight bearing and a lengthy recovery. Recovery after OLT treatment varies depending upon the nature of the lesion and the treatment. • A direct injury to the ankle (such as an object hitting where the talus joins the leg bones) Return to activity or sport can usually take place in a number of weeks to many months and should be guided by the treating physiotherapist and specialist. Thanks again for responding. I am so afraid of not being able to walk without assistance I could cry. 2. Try again. Postoperative treatment involves non-weightbearing for four to six weeks following surgical intervention. Most studies show that full resolution of the pain from an OLT occurs in less than half of … Join the conversation! The individual procedures require varying degrees of non-weightbearing time periods as well as varying degrees of early range of motion and physical therapy. My dr. will only do OATS if the lesion grows to 1cm. Lateral ankle ligament reconstruction is a surgery to tighten and firm up one or more ankle ligaments on the outside of your ankle. If the ankle arthroscopy fails to relieve pain or the talar dome lesion is very large, a type of Cartilage Resurfacing Surgery may be recommended. In the majority of cases there is a severe inversion sprain along with a resulting dorsiflexion of the foot (the ankle turns inward and at the same time the foot is jerked upwards). © 2020 MH Sub I, LLC dba Internet Brands. I was able to manage it conservatively by orthotics, not running, etc but have had ongoing problems since I wore fins in the pool a couple of years back. Try again. Little to no weight should be placed on the ankle during that time, but this will be a … OLTs can be an incidental finding on an MRI ordered to assess another problem. It occurs when a small segment of bone begins to crack and separate from its surrounding region due to a lack of blood supply. The articulation of the talar dome and the trochlear surface (tibia and fibula) supports the weight of the body. Well, I certainly didn't want to go through an ankle replacement so I agreed on the Debridement/drilling of the talar dome surgery. 5. In June 2007 I underwent debridement and microfracture surgery, with an 85% chance of success. An osteochondral lesion of the talus (OLT) is an area of abnormal, damaged cartilage and bone on the top of the talus bone (the lower bone of the ankle joint). Talar dome lesions are usually caused by … I had one doc recommend that procedure along with ligament repair. The results of non-surgical treatment of OLTs have been disappointing. Most approaches require a time of restricted movement and minimal weight bearing for weeks or in some cases, months. This dome is coated with a layer of strong cartilage to facilitate effective ankle movement. Your ankle is a hinge joint that allows motion up and down, and from side to side. Yesterday when I got home from the dr.'s appt...where he said I could "start" putting weight on the ankle/foot I was so upset because of the terrible pain I had upon putting just the weight of trying to stand with I'd say 80% of the weight on my good foot (right)....I have had 3 children, surgery for abdominal incision hysterectomy but nothing compares to the pain I had when trying to put weight on this left foot. If the lesion is on the dome, it is drilled straight down from the top. This early motion helps to prevent return of the adhesions and promote faster recovery. According to my new dr. (the one who did the surgery moved away), the increased size "could" be due to the surgery itself. Talar dome lesions are usually caused by … Usually the top or dome is affected and thus we end up with a fracture of the dome. Disclaimer Canale ST, Belding RH: Osteochondral lesions of the talus. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). Then I went to a walker when I jointed PT and after about a week or so with it I got a cane and now, after all of that I am finally able to get around with just taking the cane as a security thing... My toes still swell if I am up too long on the ankle but the surgeon said (Dec. 2nd) that it was not unusual after 2 months post surgery to have the foot swell a bit. The ankle bone is called the talus, which is topped by the talar dome linking to the tibia (shin bone). It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). Foot Ankle Clinics 8(2): 259-273, 2003. I don't think it ever went away. All rights reserved. I have no more electric shock feelings when I stand and I think the ankle is better. My drilling worked for awhile, well, at least the pain was gone for a bit. 3. JBJS 62(1): 97-102, 1980. 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