Cartilage • subchondral bone • deep pain
Osteochondral lesion of the talus
An osteochondral lesion affects cartilage and the bone just beneath it, most often in the talus. It may follow a sprain or trauma and cause persistent ankle pain.
What symptoms may suggest this condition?
- Deep ankle pain with activity, sometimes difficult to localise.
- Swelling, stiffness, locking or catching sensations.
- Persistent pain after a sprain that does not recover as expected.
How is the diagnosis confirmed?
X-rays can be normal, especially with smaller lesions. MRI assesses cartilage and subchondral bone; CT helps define size, location and any fragment or cyst.
Is surgery always necessary?
Some lesions, particularly small stable ones, can be treated with activity modification, physiotherapy and a period of protection or unloading depending on symptoms. Persistent pain despite treatment warrants reassessment.
When should surgery be discussed?
Surgical treatment depends on lesion size, depth, stability, chronicity and previous treatment. It may range from arthroscopic debridement/bone stimulation to cartilage restoration or grafting techniques for larger lesions.
Source patient : AOFAS / AAOS. General information, to be adapted to each clinical situation.
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