What is it?
An osteochondral lesion is damage to the cartilage and the bone beneath it. Small lesions may heal or remain stable; larger or unstable lesions can cause ongoing pain and contribute to arthritis.
What causes it?
- Ankle sprains and fractures
- Repeated minor trauma
- Occasionally no clear injury
What does it feel like?
- Deep, aching ankle pain with activity
- Swelling after exercise
- Catching, locking, or clicking
- Pain that persists months after a sprain
How is it diagnosed?
X-rays may be normal. MRI or CT is usually needed to identify and measure the lesion.
When should you see a podiatrist?
- Ankle pain lasting more than six weeks after a sprain
- Recurrent swelling
- Locking or catching
Nonsurgical treatment
- Rest and protection
- A period in a boot for smaller lesions.
- Physical therapy
- Restore motion and strength.
- Injections
- For symptom relief in selected cases.
When is surgery considered?
Surgery is considered for larger or unstable lesions and for lesions that remain painful after conservative treatment.
Most lesions are treated arthroscopically, by clearing damaged cartilage and stimulating the bone to form repair tissue. Larger lesions may need cartilage grafting techniques.
Related procedures
What is recovery like?
Several weeks of protected weight-bearing to allow repair tissue to form, followed by rehabilitation over a few months.
Frequently asked questions
Why did my X-ray look normal?
Cartilage does not show on X-ray. An MRI is often needed to see the injury.