Osteochondritis dissecans (OCD) is a condition where the blood supply to the bone and cartilage in the ankle joint is interrupted, often due to trauma. If left untreated, it can lead to the detachment of a bone fragment inside the joint, resulting in chronic pain. While rare, osteochondritis primarily affects young athletes, particularly those involved in sports requiring repetitive movements such as jumping and pivoting.

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Causes of Osteochondritis

Osteochondritis typically develops due to a prior injury to the talus bone, commonly caused by a sprained ankle. The injury can disrupt the bone’s blood supply, leading to the condition. Factors contributing to osteochondritis include:

  • Ankle Injury: A severe sprained ankle can fracture the talus bone. If the fragment moves, it can cause pain. Even minor sprains can damage the articular surface of the talus, reducing blood flow to the bone.
  • Loss of Blood Supply: Vascular insufficiency (reduced blood flow) can also lead to osteochondritis, eventually causing bone tissue to die.

Symptoms of Osteochondritis

The progression of osteochondritis can be slow or rapid. Initially, the bone and cartilage may stay intact, causing only minor discomfort. As bone fragments detach, pain tends to worsen. Symptoms include:

  • Ankle instability (a feeling of the ankle giving way)
  • Ankle stiffness, especially after resting
  • Limited range of motion
  • Pain, often triggered by physical activity
  • Swelling of the ankle joint

Treatment of Osteochondritis

The treatment approach depends on the severity of the condition. If the damage is minimal, rest and conservative measures may be sufficient. However, if a lesion forms or bone fragments detach, more intensive treatment may be required.

Conservative Treatment

Initially, doctors may recommend non-invasive treatment options to manage pain, including:

  • A brace to immobilize the joint
  • Anti-inflammatory medications to reduce pain and swelling
  • Limiting physical activity, especially sports
  • Physical therapy to strengthen the joint
  • Resting the ankle to reduce strain

Surgery

If symptoms persist for more than three months, or if conservative treatments fail, surgery may be considered. Surgical options include:

  • Removal of loose bone fragments
  • Reattachment of loose cartilage
  • Bone drilling to promote blood flow to the area

The goal of surgery is to restore blood flow to the joint and improve mobility, helping prevent further damage and improve function.