Osteochondral Defects

What is an osteochondral defect?

An osteochondral defect is an area of damage involving both the cartilage and the underlying bone.

It commonly affects the talus within the ankle joint and can occur following an ankle injury.

What symptoms and signs might I experience?

• Persistent deep ankle pain.
• Swelling.
• Pain during or after exercise.
• Catching or locking.
• A feeling of instability.
• Reduced ankle movement.
• Persistent symptoms following an ankle sprain.

How is it diagnosed?

X-rays are usually the first investigation.

MRI or CT may be required to assess the cartilage and underlying bone in more detail.

How is it treated without surgery?

Depending on the size and stability of the defect:

• Activity modification.
• Temporary reduction in weight-bearing.
• Immobilisation in selected cases.
• Physiotherapy.
• Progressive strengthening.
• Pain relief.
• Monitoring with imaging.

When might surgery be considered?

Surgery may be considered if symptoms persist or if the defect is unstable or significant.

What might surgery involve?

Possible procedures include:

• Arthroscopic debridement.
• Microfracture or bone marrow stimulation.
• Fixation of a suitable cartilage/bone fragment.
• Osteochondral grafting.
• Other cartilage restoration procedures in selected patients.
• Ankle fusion

The choice depends on the size, depth, location and stability of the defect.

What is recovery like?

Recovery varies considerably depending on the procedure. Some procedures require a period of reduced or non-weight-bearing before progressive rehabilitation