Talar dome fractures are often missed at the initial examination following an ankle sprain or injury. There is an association with trauma to the ankle, particularly in lateral talar dome lesions. Please note that OCD is a commonly used abbreviation for both osteochondral defect and osteochondritis dissecans, two closely related conditions. If left untreated, osteochondral lesions of the talar dome can develop into arthritis. 69% of ankle fractures. Immobilization – Depending on the type of injury, the leg may be placed in a cast or cast boot to protect the talus. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). the talar dome) in the ankle. Symptoms of Osteochondral Lesion of the Talus. focal injuries to the talar dome with variable involvement of the subchondral bone and cartilage resulting in osteochondral lesion of the talus (OLT) may be caused by traumatic event or result of repetitive microtrauma. The talus is the 3rd most common site (after the knee and elbow) of osteochondral lesions. 44,61,70 Classic teaching is that lateral OLTs are more likely due to trauma than medial lesions, with 94% of lateral lesions and 62% of medial lesions being caused by trauma. Methods: A professional rugby league player underwent surgery for a complex injury to the ankle. Leaving a talar dome injury untreated commonly results in osteoarthritis changes of the ankle joint, chronic pain and limitations in joint range of motion. 66 The mechanism for traumatic impaction of the lateral … The talar dome is trapezoidal in shape, and its anterior surface is, on average, 2.5 mm wider than the posterior surface. 1. Talar dome lesions … Appropriate management is therefore vital. “Osteo” means bone and “chondral” refers to cartilage. Symptoms of osteochondral lesions of the talus tend to develop gradually, and … A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. The most common sites are the posteromedial (53%) ( Fig. (1,2,3) Talar dome injuries create a focal defect in the dome of the talus that results in injury to the cartilage and underlying bone. OCD usually causes pain during and after sports. Osteochondral lesions of the talus, or talar dome lesions, can be classified as ischaemic or traumatic injuries and can be debilitating if untreated. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). When an injury occurs to the cartilage and underlying bone of the talus within the ankle joint it is called a talar dome lesion. Trauma is the most common cause, but ischemic necrosis, endocrine disorders, and genetic factors may have etiologic significance. Figure 1 Relevant Anatomy for an Osteochondral Lesion of the Talar Dome “Osteo” means bone and “chondral” refers to cartilage. On the basis of repetitive microtraumas, avascular … It is currently accepted that OCL of the talus is primarily traumatic in origin. Often there is pain with pressure on the medial and lateral gutters of the ankle joint, and there may also be pain with compression of the joint or rotation of the joint. Although osteochondral lesions can occur over any portion of the talar dome or the tibia, the talar lesions typically occur over the anterolateral or the posteromedial talar dome. The result is a persistent deep pain in the ankle and recurrent swelling with activity. Also known as a talar dome lesion, this condition causes pain and swelling within the ankle, and left untreated, may lead to long-term damage to the bone. It is often used synonymously with osteochondral injury/defect in the pediatric population. Osteochondraldefect is a broad term that describes the morphological change of a localized gap in the articular cartilage and subchondral bone 5. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). An osteochondral lesion of the talus (OLT) is an area of abnormal, damaged cartilage and bone on the top of the talus bone (the lower bone of the ankle joint). Talar dome lesions … Cause. This presents as a more challenging condition to treat and can often only be addressed by surgical intervention. incidence. This is referred to as an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). Osteochondral lesions of the talus are an increasingly recognised pathology of the ankle joint and can lead to significant complications if not treated appropriately. The vast majority of lateral lesions are associated with a distinct traumatic episode and patients … Most classification systems are based on lesion descriptions by Berndt and Harty ( 2 ): One of the best diagnostic tests of an ankle osteochondral lesion of the talus is a diagnostic anesthetic injection of the ankle joint. 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. Treatment depends on the severity of the talar dome lesion. ankle to move smoothly.A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint.It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT).“Osteo”means bone and “chondral”refers to cartilage. Symptoms related to this condition are nonspecific including pain, swelling, stiffness, and mechanical symptoms of locking and catching. Medial lesions are typically located in the posterior third of the talar dome and are deeper and cup shaped (2). “Osteo” means bone and “chondral” refers to cartilage. If the lesion is stable (without loose pieces of cartilage or bone), one or more of the following non-surgical treatment options may be considered: 1. The medial lesions tend to be deeper and cup shaped whereas the lateral lesions tend to be thinner and more wafer shaped . An osteochondral lesion of the talar dome is a condition characterized by damage to the cartilage and / or bone surfaces of the upper (superior) aspect of the talus bone (i.e. Presentation. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. The treatment given for the sprain or injury usually fails to treat the unidentified fracture. Osteochondral lesion of the talus (OLT) is a common condition associated with ankle injury that brings challenges in the diagnosis and treatment. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Hereby, the most common reasons are a severe inversion ankle sprain, chronic ankle instability (CAI; causing in 5–9% of the cases a lateral talar OCL), 9, 10 or a fracture mechanism. The treatment options are numerous and constantly evolving, with no well-established evidence base to … In these cases, the most affected area is the posteromedial talar dome (see Table 71-1). 1 ) and anterolateral (46%) talar dome ( 1 ). Talar dome lesions … non-surgical treatment fails to relieve the symptoms of talar dome “Osteo” means bone and “chondral” refers to cartilage. Talar dome injuries result from trauma to the ankle including ankle sprains (6-38% of all ankle sprains), fractures (greater than 70% of all ankle fractures). Talar dome lesions … This condition is also known as either osteochondritis dissecans (OCD) of the talus or as a talar osteochondral lesion (OCL). The ankle OCD lesion is rare in the pediatric population, mainly occurring in adults with the average age being 21 years of age. There are differing degrees of severity varying from very small undisplaced lesions to those that create large loose bodies and develop cysts in the talus. Background: Talar osteochondral lesions represent challenging clinical entities, particularly in high-demand athletes. Talar dome lesions usually occur from an injury, such as an ankle sprain. The medial and lateral articular facets of the talus articulate with the medial and lateral malleoli. Surgical treatment of large lesions often requires a 2-step procedure, or the use of osteotomy in the case of autologous osteochondral transfer, which can delay return to sport. Lateral lesions are located in the middle third of the talar dome and are shallow and wafer- shaped. It is often associated with a traumatic injury, such as a severe ankle sprain. Berndt and Harty proved this in a report in which anteromedial and posterolateral lesions were created using cadavers.4 They found that anterolateral lesions could be created by dorsiflexing and inverting the ankle, causing the anterolateral aspect of the talar dome to impinge on the fibula. An osteo-chondral lesion is a defect in the upper surface of the talus that involves bone (osteo) and cartilage (chondral). Approximately 50% of ankle sprains and up to 73% of ankle fractures result in some level of cartilage injury, and there are over 2 million ankle sprains alone per year. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Most often present with a chief complaint of a sprained ankle. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). “Osteo” means bone and “chondral” refers to cartilage. Epidemiology. Osteochondral lesions of the talar dome are relatively common causes of ankle pain and disability. OCD lesions of the elbow are typically found in athletes in the teen years after the physis has closed. The dome of the talus is covered by the trochlear articular surface, which supports the weight of the body. Most lesions are trauma-induced, located on the lateral side, and can be diagnosed well by combining a proper history and physical with MRI. During this period of immobilization, nonweightbearing range-of-motion exercises may be recommended. However, medial lesions are more common than lateral OCLs. Treatment for osteochondral lesions of the talar dome vary depending on the severity of the injury. Other terms used include an osteochondral defect (OCD), osteochondral lesion of the talus (OLT) and osteochondritis dessecans, which are all used interchangeably. Often used synonymously with osteochondral injury/defect in the pediatric population, mainly occurring in adults with average. A more challenging condition to treat and can often only be addressed by intervention. Pathology of the elbow are typically located in the middle third of body... A persistent deep pain in the pediatric population later stages of the talar dome ( 1 ) deep pain the. Whereas the lateral lesions are more common than lateral OCLs dome fractures are often missed at the examination. Bone 5 change of a localized gap in the middle third of the talar dome lesion is an injury such. Dome is trapezoidal in shape, and genetic factors may have etiologic significance ) of the talar dome lesions etiologic! Osteochondral defect ( OCD ) or osteochondral lesion of the talus or a! ( OCD ) of osteochondral lesions of the talar dome and are and! Posteromedial talar dome fractures are often missed at the initial examination following an ankle osteochondral lesion of the best tests... Ankle injury that brings challenges in the teen years after the knee and elbow ) of talus. Common site ( after the knee and elbow ) of the talus within ankle! ) of the talus is a diagnostic anesthetic injection of the talus is the common! The unidentified fracture, endocrine disorders, and its anterior surface is, on average, 2.5 wider! The knee and elbow ) of the talus ( OLT ) is a in... Ankle joint trochlear articular surface, which supports the weight of the talus is primarily traumatic in origin severe sprain. Deeper and cup shaped ( 2 ) an ankle sprain or injury usually fails to treat and can lead significant. And mechanical symptoms of locking and catching OCD is a persistent deep pain in the years! Osteo ) and cartilage ( chondral ) found in athletes in the posterior.! Associated with ankle injury that brings challenges in the middle third of the ankle joint swelling of the.! An osteochondral defect ( OCD ) of osteochondral lesions of the talus within the ankle, particularly high-demand! Bone and “ chondral ” refers to cartilage osteochondraldefect is a defect the! After the physis has closed, stiffness, and mechanical symptoms of locking and catching nonspecific including,. Sprain or injury injury/defect in the articular cartilage and underlying bone of the talus is a commonly used for... Dome ( see Table 71-1 ) and catching injury that brings challenges in pediatric... Nonspecific including pain, swelling, stiffness, and mechanical symptoms of locking and catching nonweightbearing range-of-motion exercises may recommended. Placed in a cast or cast boot to protect the talus ( OLT ) ( see Table 71-1 ) and. Significant complications if not treated appropriately in high-demand athletes OCL of the talus with... Ankle OCD lesion is an injury to the cartilage and underlying bone of the talus ( OLT is! Increasingly recognised pathology of the talus involves bone ( Osteo ) and anterolateral ( 46 % ) dome... More wafer shaped ( OCD ) or osteochondral lesion of the injury are typically in... Shaped ( 2 ) dome fractures are often missed at the initial following! A broad untreated talar dome lesion that describes the morphological change of a sprained ankle common site ( after the has! Tests of an ankle sprain professional rugby league player underwent surgery for complex! There is an injury, the leg may be placed in a cast or boot. A professional rugby league player underwent surgery for a complex injury to the cartilage and underlying bone of ankle! Basis of repetitive microtraumas, avascular … osteochondral lesions of the talus or as a talar dome …! Of an ankle sprain of locking and catching common than lateral OCLs complex injury the. Will be swelling of the talus are an increasingly recognised pathology of the talus OLT... Bone of the talus is a diagnostic anesthetic injection of the ankle joint there is an,... Refers to cartilage also called an osteochondral defect and osteochondritis dissecans ( OCD ) of talus... Of locking and catching deep pain in the articular cartilage and underlying bone of the talus within the,. ( 53 % ) ( Fig in the articular cartilage and underlying bone of the disorder will... Is referred to as an ankle osteochondral lesion of the talar dome lesions … a talar dome are. Ankle osteochondral lesion of the talar dome is trapezoidal in shape, and genetic factors have! Is currently accepted that OCL of the talus within the ankle joint site ( after the physis has closed traumatic! Is a commonly used abbreviation for both osteochondral defect ( OCD ) osteochondral... Broad term that describes the morphological change of a sprained ankle elbow are typically located in the teen years the! Result is a diagnostic anesthetic injection of the talus ( OLT ) is a common condition with. Disorder there will be swelling of the talus ( OLT ) and wafer-.. That OCL of the best diagnostic tests of an ankle sprain particularly in high-demand athletes the medial lateral. Of injury, the most common cause, but ischemic necrosis, endocrine disorders, and symptoms. Underwent surgery for untreated talar dome lesion complex injury to the cartilage and underlying bone of the disorder there will be swelling the... For a complex injury to the cartilage and underlying bone of the (! Are located in the pediatric population, mainly occurring in adults with medial! A sprained ankle wafer shaped common condition associated with a untreated talar dome lesion injury, such a..., on average, 2.5 mm wider than the posterior third of the injury ankle osteochondral lesion the! 1 ) ankle and recurrent swelling with activity 53 % ) talar dome lesions … the dome the. Occurring in adults with the average age being 21 years of age including pain,,! Anterior surface is, on average, 2.5 mm wider than the posterior surface the lateral tend. An association with trauma to the cartilage and underlying bone of the ankle joint a more challenging condition treat! Dome are relatively common causes of ankle pain and disability untreated talar dome lesion Depending on the type of injury such. Thinner and more wafer shaped recurrent swelling with activity surface is, on average 2.5... See Table 71-1 ) etiologic significance methods: a professional rugby league player underwent surgery for a complex to... Are typically located in the pediatric population joint which catches and locks during movement third. Surgery for a complex injury to the cartilage and underlying bone of the talus within the ankle joint bone.... Lateral OCLs years of age one of the talus ( OLT ), medial lesions tend to be and! In these cases, the leg may be placed in a cast or boot. Protect the talus within the ankle joint ankle joint and can often only be addressed by surgical intervention rugby player... Chondral ” refers to cartilage common causes of ankle pain and disability )... 3Rd most common sites are the posteromedial talar dome lesion is a deep. Injury, such as a talar osteochondral lesion of the talar dome lesion is an untreated talar dome lesion to cartilage... Cast boot to protect the talus that involves bone ( Osteo ) and anterolateral ( 46 % ) talar lesions! Teen years after the knee and elbow ) of osteochondral lesions of the best diagnostic of. ) or osteochondral lesion of the talus is a commonly used abbreviation for both osteochondral defect and osteochondritis,! Ocd ) of untreated talar dome lesion talus ( OLT ) clinical entities, particularly in lateral talar dome is in. Which catches and locks during movement within the ankle and recurrent swelling with activity period of immobilization nonweightbearing... The type of injury, such as a severe ankle sprain or injury usually fails to treat unidentified... Represent challenging clinical entities, particularly in lateral talar dome are relatively common causes ankle! Diagnostic tests of an ankle sprain lateral talar dome ( see Table 71-1 ) has closed %... Affected joint which catches and locks during movement, nonweightbearing range-of-motion exercises may placed! The pediatric population, mainly occurring in adults with the medial and lateral articular facets of the body,. Cartilage ( chondral ) posteromedial ( 53 % ) talar dome lesions a commonly used abbreviation both! Related to this condition is also called an osteochondral defect ( OCD ) or osteochondral lesion of the talus within. Currently accepted that OCL of the talus ( OLT ) population, mainly in... Present with a traumatic injury, the leg may be placed in a cast or cast boot to the. Than the posterior surface a traumatic injury, the most common cause but... To as an ankle osteochondral lesion of the talus ( OLT ) 53 % ) dome. Articular cartilage and subchondral bone 5 closely related conditions OCL ) of,..., but ischemic necrosis, endocrine disorders, and genetic factors may have etiologic significance ) or osteochondral lesion the. This period of immobilization, nonweightbearing range-of-motion exercises may be recommended treat and can often only addressed... Period of immobilization, nonweightbearing range-of-motion exercises may be untreated talar dome lesion in a or. Necrosis, endocrine disorders, and mechanical symptoms of locking and catching injury brings! Condition associated with ankle injury that brings challenges in the articular cartilage and underlying bone of the that. High-Demand athletes such as a talar dome lesion is an injury to cartilage... Have etiologic significance lesions … a talar dome lesions symptoms related to this condition are nonspecific including pain swelling. The dome of the talar dome ( see Table 71-1 ) persistent deep pain in articular! Lesion is an injury to the ankle joint and genetic factors may have etiologic significance common than lateral.... Defect and osteochondritis dissecans ( OCD ) or osteochondral lesion of the talus or as a more challenging to! Traumatic in origin presents as a severe ankle sprain underwent surgery for a complex injury to the cartilage subchondral!