Osteochondritis dissecans of the ankle tends to have a low level of chronic persistent pain, a variable amount of swelling which is often intermittent and not severe. Those that fail to respond may be candidates for v… The ankle joint is the most commonly injured joint in athletes, and OCD lesions primarily are found in the ankle (Giovanni et al, 2007). However, it can also occur from chronic overload due to malalignment or instability of the ankle joint. Most cases of OCD usually follow a twisting injury to the ankle and are actually fractures of the joint surface. There are also possible links to hereditary conditions, poor blood supply to the injured area and compression trauma. It occurs when a small segment of bone begins to separate from its surrounding region due to a lack of blood supply. The presence of an osteochondral lesion may initially go undetected and may manifest many months after the initial ankle injury. OCD is a type of osteochondrosis in which a lesion has formed within the cartilage layer itself, giving rise to secondary inflammation. These various types of damage are called osteochondral defects (OCD) of the talus (an older term was osteochondritis dissecans). This injury may lead to the cartilage coming loose from the bone to which it is normally stuck to. Symptoms of osteochondritis dissecans are similar to that of a severely sprained ankle and include: Pain Swelling Difficulty putting weight on the ankle Discomfort or an odd sensation when moving the ankle joint This may lead to small cracks in the cartilage or even formation of a hole or cyst underneath the surface. Treatment for this may be different then in the early stages of the OCD lesion. Some cases may not have any previous history of ankle injury, and may be caused by local osteonecrosis or a metabolic defect. Dr. Shani removes or repairs damaged articular cartilage and removes bone cysts that have formed. Pain within the ankle joint, usually worse on activities. OCD is often diagnosed with the help of an X-ray because it can easily reveal that a fragment has chipped off of the larger bone. If the cartilage does not heal properly following the injury, it softens and begins to break off. Osteochondritis dissecans (OCD) of the ankle is the end result of the aseptic separation of an osteochondral fragment of the talar dome with the gradual fragmentation of the articular surface.See the main osteochondritis dissecans article for a general discussion on … He recommends intervening early if your young gymnast or athlete complains of pain in their joints. This technique is effective in approximately 85% of cases. These are termed Osteochondral defects, or an OCD. It is often associated with a traumatic injury such as a severe ankle sprain. He complains of mechanical symptoms with ankle movement that continue to be symptomatic with everyday activities. Wearing an ankle brace may help protect the patient from re-injury if the ankle is unstable. © 2020 Rady Children's Hospital–San Diego, COVID-19 Updates: Latest Information for Parents. OCD usually causes pain during and after sports. The length of time away from activities depends on the child’s symptoms and how the follow-up X-rays look. Which joints are most commonly affected by OCD? Often, a CT scan or MRI may be needed to confirm the diagnosis and determine the location and size of the damage. It is often associated with a traumatic injury such as a severe ankle sprain. a loss of blood supply to one or more bones in the ankle, which may result in a fracture or break within the ankle joint. Mercy doctors and specialists have offices in Baltimore, Columbia, Overlea, Lutherville, Glen Burnie and Reisterstown. In case of an Emergency, Dial 911 and follow the instructions of the EMS (Emergency Medical Services) team. Symptoms of Ankle OCD. Unlike arthritis of the knee, the degeneration of the knee joint occurs quite quickly. It affects the articular cartilage (the smooth covering of the ends of bones) and subchondral bone (bone underneath the cartilage), which becomes separated from the rest of the bone. In OCD, a portion of the bone or cartilage separates from the surface of the joint and creates pain, swelling and sometimes a locking sensation. Here are the injuries we're tracking. Compression of subchondral bone – non surgical II. Cartilage on the outside of this joint, called the articular surface, provides the smooth gliding between the ankle joint and the underlying bone that supports it (the talus). The ankle bone, (the talus) can develop tears in the cartilage lining of the joint, which then also form cysts in the bone underneath. Osteochondral injuries are most often caused by trauma to the ankle joint, such as with ankle sprains. 1955 – Older age group: • 2 nd through 4 th decade • Average age 25 years – More on lateral side – More prone to develop OA. Osteochondritis dissecans (OCD) is a problem that causes pain and stiffness of the ankle joint. It can cause symptoms either after an injury to a joint or after several months of activity, especially high-impact activity such as jumping and running, that affects the joint. However, it can also occur from chronic overload due to malalignment or instability of the ankle … (OBQ12.74) A 21-year-old male reports right ankle pain after sustaining an inversion ankle injury 2 years ago. The hospital is recognized for expert doctors and Centers of Excellence in Women’s Health & Medicine, Orthopedics, Cancer, and Digestive Health & Liver Disease. Minor events lead to bruising of the talus. “Osteo” means bone and “chondral” refers to cartilage. Patients experience pain, ankle swelling, clicking in the ankle. Osteochondral Defects/Injuries Treated by Mercy's Ankle Surgeons The surgeons at The Institute for Foot and Ankle Reconstruction at Mercy in Baltimore provide expertise in the diagnosis and treatment of osteochondral defects. Small instruments are then inserted into the joint to clean out inflammation and debris. Mercy Medical Center's downtown campus includes our Main Hospital - The Mary Catherine Bunting Center, McAuley Plaza and The Weinberg Center. A variety of terms have been used to refer to this clinical entity, including osteochondritis dissecans (OCD), osteochondral fracture and osteochondra … Treatment principles for osteochondral lesions in foot and ankle Int Orthop. If a large part of the joint is affected, or if pieces of bone and cartilage have already come loose, surgery should be performed. OCLs most commonly occur in two areas of the talus: Immobilization of the ankle, medications, steroid injections and physical therapy are commonly tried but this often fails to relieve symptoms and surgery may be required. 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. Ankle arthroscopy can help locate and remove the loose bodies. Dr. John Campbell treats routine and complex foot and ankle disorders, including osteoarthritis, sprained ankle and Achilles tendinitis, as well as total ankle replacement. A 2020 TOP DOC Dr. Douglas Buethe is a Board Certified dermatologist providing general dermatologic care for patients with conditions of the skin, scalp and hair. Choi et al. 1. repetitive throwing / valgus stress and gymnastics / weight bearing on upper extremity 1.1. valgus stress / compressive force on the vulnerable chondroepiphysis of the radiocapitellar joint in skeletally immature patients is supported as the aetiology for OCD of the capitellum 8 2. ankle sprain/instability 2.1. Many of our doctors have been named among Baltimore’s best doctors. Occasionally, more extensive surgeries may need to be performed for cartilage repair. The most common surgical treatment is. OCD is an abbreviation which can stand for either Osteochondritis Dissecans or Osteochondral Defect. At East Ocean Podiatry in South Florida, our board-certified podiatrists, Dr. Dorfman and Dr. Sansone, are at the leading edge of podiatric treatments. cartilage injury with associated subchondral fracture but without detachment Though in a majority of cases there is a history of injury or trauma, some cases may not have any previous history of ankle injury. A 2020 TOP DOC After a long journey and years of living with a chronic disease, a patient gets back on his feet - literally. The ankle joint may lock up too. General visiting hours at Mercy are 11:00 am to 8:30 pm. If only the cartilage is damaged it is termed chondral and if the cartilage and bone is involved then the diagnosis is a osteochondral lesion. OCDs are typically caused by an injury, such as an ankle sprain or at times an ankle fracture. Mercy Medical Center is proud to have been named one of America's 100 Best Hospitals for Orthopedic Surgery. The severity of the injury is best assessed using MRI. As the injury is intra-articular an MRI is required to diagnose the extent of the injury. Ankle pain can also be caused by a fracture of one of the bones in the ankle. X-rays of the ankle are routinely obtained but may not identify an OCD in almost 50% of cases. In some cases of undiagnosed OCD ankle injuries, patients must undergo arthroscopic or open surgery to repair the damage. Lateral talar lesions are more common than medial lesions. Most cases of OCD usually follow a twisting injury to the ankle and are actually fractures of the joint surface. However, it can also occur from chronic overload due to malalignment or instability of the ankle joint. Without blood flow, the area of damaged bone actually dies. These often cause swelling and pain, and can be associated with catching or sharp intermittent pain in the ankle. People take their ankles for granted, and it shows in the frequency and mechanism of injuries to this joint. The ankle joint is an articulation of the end of the tibia and fibula (shinbones) with the talus (heel bone). An osteochondral ankle defect is a lesion of the talar cartilage and subchondral bone mostly caused by a single or multiple traumatic events, leading to partial or complete detachment of the fragment. Multiple tiny incisions are made around the ankle and a small camera is inserted to inspect the joint. If there are symptoms, they may include: A physical exam can rule out other problems, but an X-ray will usually secure the diagnosis. It can occur in all age groups. Patients can have three different kinds of complaints, whether or not in combination: 1. OCD most commonly affects the knee, although it can affect other joints such as the ankle or the elbow. Sometimes an ankle sprain may also result in an osteochondral injury. Multiple tiny incisions are made around the ankle and a small camera is inserted to inspect the joint. Osteochondritis dissecans (OCD) is a localized injury or condition affecting an articular surface that involves separation of a segment of cartilage and subchondral bone (Schenck, 1996). If only bruising of the bone is present, resting the ankle may be all that is required. X-rays of the ankle are routinely obtained but may not identify an OCD in almost 50% of cases. I'm 26 and have about 5 chronic injuries. Dr. Cohen warns that OCD is increasing in young athletes, especially in gymnasts. This condition is one in which a piece of bone and cartilage within a joint are damaged and in some cases separate from the underlying bone. As a result I can barely do any exercise (can't do anything that impacts my ankle) and even have to cook with one hand. As a result, the small piece of bone and the cartilage covering it … This guide will help you understand Results: A total of 104 patients with chronic ankle instability were included in this study. A condition known as osteochondritis dissecans is characterized by damage and separation of a piece of bone and cartilage within the joint,from the underlying bone. Mercy offers emergency care on the Downtown Baltimore campus 24 hours a day, 7 days a week (410-332-9477) with access to a trained emergency medicine team, diagnostic services and consultations with specialists. 2013 Sep;37(9):1697-706. doi: 10.1007/s00264-013-2076-1. The most common surgical treatment is arthroscopy of the ankle. This condition is also known as either osteochondritis dissecans (OCD) of the talus or as a talar osteochondral lesion (OCL). The fragments may be smooth and still si… It is often associated with a traumatic injury, such as a severe ankle sprain. Osteochondritis dissecans (OCD) of the talus (ankle bone) happens when repetitive trauma results in a blood supply injury to the talus and the bone either fails to develop from the cartilage your kid was born with, or the maturing bone dies and therefore softens and collapses. The Institute for Foot and Ankle Reconstruction is part of The Orthopedic Specialty Hospital at Mercy Medical Center. Top. The natural causes of osteochondral injuries are still not clear.. Depending on the amount of damage to the cartilage in the ankle joint, arthritis may develop and limit joint motion. If non-surgical approaches fail to relieve the symptoms of an OCD, surgery may be necessary. Among them, 33 patients had cartilage injury on the talus (OCD group), and the other 71 patients had no cartilage injury (control group). It occurs most often in the knee and next most often in the ankle. Healthy joints move easily because of a smooth, slippery tissue called articular cartilage. Return to sports rate after microfracture is reported to be 76%, though most patients may not be able to achieve the pre-injury level. Pain that gets worse with activity and improves with rest. Other symptoms include tenderness and swelling of the ankle joint with difficulty in weight bearing. There is often a history of multiple ankle problems that do not have a clear cause or diagnosis. While initial symptoms may be similar to a sprained ankle, persistent pain, swelling, and a catching sensation while using the ankle may indicate this more serious condition. Talar dome lesions are usually caused by … A microfracture can then be performed by drilling holes into the underlying bone to fill the crater with a blood clot containing proteins and cells to restore a smooth surface. The diagnosis of cartilage damage (osteochondral lesion, also known as talar dome) is often done with x-rays and/or an MRI. Our office offers the latest advancements in technology to help our young patients find relief from chronic ankle pain. Ankle OCD What is Ankle OCD? Difficulty putting weight on the ankle Discomfort or an odd sensation when moving the ankle joint Diagnosis and Treatment of Osteochondritis Dissecans If your symptoms linger longer than expected, or if your ankle injury is severe enough to warrant an X-ray, you’ll head in for imaging tests. Symptomatic osteochondral ankle defects often require surgical treatment. Knee Osteoarthritis. However, the exact cause of osteochondral injuries is not yet fully understood. In the talus, 96% of lateral lesions and 62% of … Posteromedial lesions occur when the foot is plantarflexed during inversion, whereas anterolateral lesions occur when the foot is dorsiflexed. The top rated team of doctors and surgeons at The Institute for Foot and Ankle Reconstruction at Mercy Medical Center in Baltimore, Maryland, is recognized as one of the region’s best programs for foot and ankle reconstruction and injury. Treatment depends on the severity of the osteochondral injury. Symptoms. how OCD develops; how the condition causes problems Osteochondritis dissecans (OCD) is a condition that develops in joints, most often in children and adolescents. On images it is easy to see the extent of damage to the surface of the cartilage. Osteochondral lesions of the talus are a reasonably infrequent cause of long-standing ankle pain and stiffness and are often the result of a severe ankle sprain type injury. OCD (osteochondritis dissecans), on the other hand, is considered a chronic process that can go on for months to years before any symptoms are felt. Causes of Ankle OCD. The OCD often requires a long period of rest from sports to allow for healing. We know that this latter situation can lead to early arthritis. Most often, there are no symptoms of talus OCD. With an MRI, the ligament structures, tendons and cartilage of the ankle can be examined and analyzed. Patients rely on our ankle specialists to provide advanced treatment options to help relieve pain from ankle injuries and restore mobility. In the cartilage surfaces of the ankle are routinely obtained but may not identify OCD. Different then in the ankle are routinely obtained but may not identify OCD... 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