Osteochondral Lesion of the Talus (OCD)
Deep ankle pain that does not settle after a sprain.
This is damage to the cartilage and bone of the talar dome, often after an ankle sprain. Patients describe deep ankle pain, swelling, and catching that simply does not go away. MRI and CT help define the lesion. Small stable lesions may heal with offloading and rehabilitation, while larger, unstable, cystic, or failed lesions often need surgery.
Symptoms
- Deep ankle pain
- Swelling after activity
- Catching or locking
- Persistent pain after a sprain
Conservative treatment
- Boot and offloading
- Activity modification
- Physical Therapy
- Bracing and proprioception
When is surgery needed?
Arthroscopy with debridement and microfracture for smaller lesions; grafts or cartilage reconstruction for larger or cystic defects.