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What is an osteochondral lesion of the talus?
It is damage to the cartilage and the bone just beneath it on the surface of the talus, the ankle bone that joins the tibia. It often appears after an ankle sprain or fracture, though sometimes there is no clear history.
What symptoms does it cause?
Deep ankle pain that worsens with activity, recurring swelling, stiffness and sometimes catching or locking. It is one of the most common causes of a sprain that does not heal.
How is it diagnosed?
X-rays may not show it. MRI is the most useful study to see cartilage and bone, and CT helps measure size and plan surgery.
How is it treated?
Small stable lesions may improve with rest from impact activity, protection and rehabilitation. When they cause persistent pain or are unstable, they are treated arthroscopically: cleaned and stimulated to form new tissue with microfracture, or the fragment is fixed. Large or non-responding lesions may need cartilage or bone grafts. Recovery usually includes several weeks without weight-bearing.
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