ankle pain and doctor

What Causes Osteochondral Defect in the Ankle?

What is the most likely cause of OCD Talus?

Osteochondral defect (OCD) refers to a focal area of damage, usually to cartilage and part of the bone that it surrounds. This type of damage is accompanied by pain, swelling, and mechanical impairment. In the ankle, this condition is typically associated with the talus bone, which is one of the three bones that make up the joint and is referred to as OCD Talus. 

In addition to the talus, the other bones in the ankle joint are the tibia and the fibula from the lower leg. These two bones, which are parallel to each other in the leg, meet up with the talus to form the joint, with the talus being the connection point between the leg and foot. Because it bears the weight of the entire body, including the additional stress created by movements like walking and running or sudden shifts in direction, the talus is an extremely dense and compact bone. It is also protected by a covering of articular cartilage, which is stronger than other types of cartilage and helps in absorbing stress and shocks, as well as facilitating smooth joint movements.

What Causes OCD Talus?

Determining the exact cause of OCD talus is not always possible. The condition has been linked to a genetic predisposition in some and to repetitive stress on the ankle in others, especially athletes. These can lead to progressive damage to the cartilage over time. It is believed, however, that the most common cause of OCD talus is trauma. 

Based on reports published by the National Center for Biotechnology Information (NCBI), which is a branch of the National Institutes of Health (NIH), there are 2 million ankle sprains in the U.S. each year. OCD talus is linked to a larger percentage of those sprains. In fact, 70% of ankle sprains are accompanied by OCD talus and the same percentage is true of ankle fractures.  

Symptoms of OCD Talus

Every injury is different and the symptoms can vary from one individual to the next. Depending upon the level of trauma and the body’s success at healing, there may not be noticeable symptoms of damage to the cartilage or talus bone for quite some time. If healing is unsuccessful, the cartilage can become soft and there may be pieces that break off. Bone fragments may also break away, and, once this happens, some of the most common symptoms to appear are:

  • Ankle pain, which is the most common and can include sharp as well as a deep, dull ache, especially when putting weight on the ankle for any sort of movement
  • Swelling
  • Stiffness
  • Tenderness
  • Impaired mobility
  • Weakness, feeling like the ankle may not support body weight
  • Popping or clicking sound

There are a variety of methods available for the treatment of OCD talus, including non-surgical options as well as surgical procedures. One of the reasons that more conservative methods are often unsuccessful, especially in adults, is due to the likelihood of there being bone and cartilage fragments floating loose in the joint. This is why it is so important to consult with your orthopedist any time you have significant or ongoing pain in your ankle.   

If you have questions about an ankle injury or about any other foot or ankle concerns, Dr. Christopher Hubbard is a board-certified Orthopedic Surgeon with Ortho-Care Wayne in Passaic County New Jersey and is the former Chief of the Foot and Ankle Service at Mount Sinai Beth Israel in NYC.

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