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Oxford University Hospitals NHS Foundation Trust
Foot and Ankle

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Osteochondral defects

Osteochondral defects (OCD) presents as localised areas of joint damage and unlike arthritis OCD shows as joint surfaces softening, rather than arthritic hardening. This condition usually exists in the talus where the cartilage and underlying bone has been damaged, often through injury.

The talus (the ankle bone) is a critical bone of the ankle joint which connects the leg and the foot. The talus is involved in many aspects of movement - it joins the ankle joint and is responsible for the upward and downward movement of the ankle. It also joins the heel bone where it is responsible for most of the inward and outward movements of the foot.

If you present with OCD then the main symptom is pain, often when standing or weight bearing. It is usually (but not exclusively) limited to the side of the joint on which the osteochondral defect exists.

This condition can be treated in a number of ways by non-surgical means. Non-surgical management could involve the use of a plaster cast or a walking boot which may need to be worn for up to four months. This type of treatment is really only suitable if the OCD has been diagnosed early and there are only minor changes to cartilage and bone - historically, this type of management has shown a 40 - 50 percent success rate.

Arthroscopic debridement however is a more common surgical procedure which is used to treat most OCD defects. An MRI is used to determine the extent of the damage. Arthroscopic debridement is then performed, usually in a day surgery unit, where loose fragements of bone and other material within the defect are removed. The base of the defect is then drilled arthrosopically with fine wires or micro fractured. The drilling creates little holes and channels that allow tiny blood vessels to grow and improve the blood supply to the talus.

Your consultant will be happy to discuss all the options and implications with you, so please do ask. It may help if you write down a list of questions before you have your consultation.