Understanding.
Osteochondral lesions of the talus, also called the astragalus, can appear after trauma. They can cause deep pain, swelling, or a catching sensation.
The assessment.
X-rays are supplemented, if necessary, by an MRI or CT scan. The size, depth, stability, and presence of bone cysts guide treatment.
Treatments.
Adapted activities and weight-bearing protection may be recommended. For certain symptomatic lesions, surgery uses fixation, bone marrow stimulation, or osteochondral reconstruction. Associated instability must also be assessed.
Follow-up.
Weight-bearing protection and return to sports depend on the movement performed and the recovery.
Choosing a procedure adapted to the lesion
A viable fragment can sometimes be fixed. Small lesions may be treated with cleaning and stimulation of the underlying bone. Larger or cystic lesions may require a bone or osteochondral graft. Arthroscopy cannot treat all locations.
Protecting the repair
A period of limited weight-bearing may be necessary. Progress depends on the technique and associated procedures, particularly those involving ligaments. Repair does not guarantee cartilage identical to the original cartilage, nor does it prevent future osteoarthritis.
Your questions.
Does a lesion visible on MRI necessitate surgery?+
No. The symptoms and characteristics of the lesion guide the decision.
Why request an MRI and CT scan?+
They provide additional information about the cartilage, bone, and any cysts; both are not always necessary.
Can I run as soon as I'm pain-free?+
Pain reduction alone is not enough to guarantee healing. Adhere to the return-to-activity schedule established with the team.