Talar Dome Fracture

Cartilage damage of the ankle, also know as an osteochondral lesion of the talus or tibia, may occur from a traumatic fracture or sprain of the ankle. The bones in the ankle joint may bang against each other at the time of initial injury with damage to the cartilage surface. The initial pain may resolve with the original injury, but there may be internal pain of the ankle with activity and exercise. The pain is often a chronic aching pain with possible locking of the joint.

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Picture showing an ankle joint that has suffered damage to the cartilage following a sprain. The arrow is pointing to the area of damage on the outside of ankle.

The diagnosis of cartilage damage also known as an osteochondral lesion is often done with x-rays and/or an MRI. Initial x-rays are done to check the alignment of the foot and ankle and also check for any sort of bone damage along with the cartilage damage. With an MRI, the ligament structures, tendons and cartilage of the ankle can be checked and analyzed.

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Picture showing an MRi of the ankle in cross section from front to back. The arrow is pointing the light area on the joint cartilage where the cartilage is damaged.
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Picture showing an MRI of the ankle in cross section from side to side. The arrow is pointing the dark area on the joint cartilage where the cartilage is damaged.

Based on the size of cartilage damage, the treatment options are either arthroscopic removal of the damaged cartilage and drilling of the damaged region in order to grow new cartilage called fibrocartilage. If the lesion is large or involves the deep bone below the cartilage damage area, a transplant of fresh bone and cartilage, either from the patient’s knee or from a lab, is placed as a plug into the damaged region.

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Picture showing schematic of surgical repair of the damaged cartilage. The chip of cartilage is removed. Then the bone is drilled to encourage fibrocartilage to grow in place of the missing cartilage.
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Visible Region of Cartilage and Bone
Damage (yellow arrow) in the Ankle Joint
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Fresh Replacement Talus for
Harvest and Transplant of
Cartilage and Bone
Transplanted Cartilage and Bone
(yellow arrow) Just Prior to
Final Positioning Press Fit

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