Osteochondral Lesion of the Ankle

Osteochondral lesions are areas of damage to cartilage and underlying bone in joints. They are commonly found in the ankle on the talus following trauma. Small unstable flaps of cartilage can often be managed arthroscopically with a debridement of the loose cartilage flap and bone marrow stimulation such as microfracture. Larger areas of cartilage damage are often associated with cyst formation in the underlying bone. This is sometimes treated with an osteochondral autograft from the knee for example. It often requires an osteotomy of the tibia to gain access. The images below show a large area of cartilage damage over the talus following an osteotomy of the medial malleolus. The area of cartilage damage has been debrided and an osteochondral graft from the knee inserted into the defect. This is a major undertaking and is rarely a first line treatment.