The surgeon will select the best procedure based on the specific case.ĭepending on the amount of damage to the cartilage in the ankle joint, arthritis may develop in the joint, resulting in chronic pain, swelling and limited joint motion. A variety of surgical techniques is available to accomplish this. Surgery may involve removal of the loose bone and cartilage fragments within the joint and establishing an environment for healing. If non-surgical treatment fails to relieve the symptoms of talar dome lesions, surgery may be necessary. Wearing an ankle brace may help protect the patient from re-injury if the ankle is unstable. Physical therapy may also include techniques to reduce pain and swelling. Range-of-motion and strengthening exercises are beneficial once the lesion is adequately healed. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be helpful in reducing the pain and inflammation. During this period of immobilization, non-weightbearing range-of-motion exercises may be recommended. Depending on the type of injury, the leg may be placed in a cast or cast boot to protect the talus. Patients may describe a locking or clicking sensation, which is often. Symptoms are often worse with activities such as running, walking uphill or on uneven surfaces. 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: An Osteochondral Lesion of Talar Dome causes pain in the front of the ankle joint, or patients often describe a deep aching pain in the ankle joint that they are unable to touch. Treatment depends on the severity of the talar dome lesion. X-rays are taken, and often an MRI or other advanced imaging tests are ordered to further evaluate the lesion and extent of the injury. The most common misposition for the standing lateromedial projection of the foot shows the medial talar dome positioned anterior to the lateral talar dome. Sometimes the surgeon will inject the joint with an anesthetic (pain-relieving medication) to see if the pain goes away for a while, indicating that the pain is coming from inside the joint. To diagnose this injury, the foot and ankle surgeon will question the patient about recent or previous injury and will examine the foot and ankle, moving the ankle joint to help determine if there is pain, clicking, or limitation of motion within that joint. The signs and symptoms of a talar dome lesion may include:Ĭhronic pain deep in the ankle-typically worse when bearing weight on the foot (especially during sports) and less when restingĪn occasional “clicking” or “catching” feeling in the ankle when walkingĪ sensation of the ankle “locking” or “giving out”Įpisodes of swelling of the ankle-occurring when bearing weight and subsiding when at restĪ talar dome lesion can be difficult to diagnose, because the precise site of the pain can be hard to pinpoint. Unless the injury is extensive, it may take months, a year, or even longer for symptoms to develop. Sometimes a broken piece of the damaged cartilage and bone will “float” in the ankle. If the cartilage doesn’t heal properly following the injury, it softens and begins to break off. Talar dome lesions are usually caused by an injury, such as an ankle sprain. “Osteo” means bone and “chondral” refers to cartilage. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. The top of the talus is dome-shaped and is completely covered with cartilage-a tough, rubbery tissue that enables the ankle to move smoothly. In case of persistence and aggravation of the pain, surgery can be decided.The ankle joint is composed of the bottom of the tibia (shin) bone and the top of the talus (ankle) bone. To relieve the painful phenomena, an injection of corticoids or hyaluronic acid can also be considered. Inquire in advance is mandatory in order to perform the most suitable examination Treatment optionsĪnalgesics and anti-inflammatories as well as the wearing of an orthopedic sole constitute the first instance treatment. Your surgeon will need a an X-ray with specific profiles as well as an MRI or CT-arthrography in order to evaluate the lesions on soft tissue. The development is painful, swelling and blockages of the joint can make sporting or even walking difficult. These lesions may be of traumatic origin (sprains, instability) but also metabolic or genetic and will alter the shape and structure of the bone and cartilage (cyst, necrosis). The osteochondral lesions of the Talar dome (also called LODA) are located at the level of the bone of the foot called the talus, situated between the heel and the tibia and used to extend or flex the ankle.
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