Approaches for Treating Talar OCL
Conservative Treatment
Initial treatment of talar OCL is often conservative. This may involve such things as rest, limited weight-bearing, immobilization in a cast or boot, and use of NSAIDs. Such conservative treatment may allow for reduction of pain, resolution of edema in the bone and healing of small non-displaced fragments. Studies suggest that approximately 50% of talar OCL treated in a conservative fashion will have adequate outcomes, while the other half of cases will generally proceed to more aggressive interventions.
Sources:
Rikken, Q. G., & Kerkhoffs, G. M. (2021). Osteochondral lesions of the talus: an individualized treatment paradigm from the Amsterdam perspective. Foot and ankle clinics, 26(1), 121-136.
Wang, C. C., Yang, K. C., & Chen, H. (2021). Current treatment concepts for osteochondral lesions of the talus. Tzu-Chi Medical Journal, 33(3), 243-249.
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Surgical Interventions for Osteochondral Lesions (OCL) of the Talus
A variety of surgical approaches may be used to treat talar OCL, with the choice of procedure depending on factors such as the size, location and nature of the lesion, patient characteristics and preferences and the preferences and particular expertise of the surgeon.
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Injections to treat Osteochondral Lesions (OCL) of the Talus
There are a variety of non-surgical interventions used with talar OTL involving local injections intended either to decrease pain and inflammation (e.g. cortisone) or to enhance regeneration or maintenance of cartilage tissue (e.g. Platelet-Rich Plasma (PRP), collagen preparations).
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Joint-altering surgeries
With long-term OCL that have not responded to treatment and are causing substantial pain and dysfunction, surgical approaches may be considered that radically alter the structure and function of the ankle. These approaches include bone fusions and total ankle replacement.
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