Does your ankle randomly lock up once in a while, causing pain and stiffness in the area? The problem may be more common than you think. Oftentimes when an ankle catches or “locks up,” the individual is dealing with what’s known as an osteochondral lesion. Below, we explain what’s going on in your ankle when you develop an osteochondral lesion, and we cover common treatment options.
Causes and Symptoms of Osteochondral Lesions
An osteochondral lesion, also sometimes called osteochondritis dessicans or an osteochondral fracture, involves an injury to the talus and the nearby cartilage. The cartilage can roughen, develop cyst-like lesions or even fracture in conjunction with part of the talus bone. In most cases for an osteochondral problem to develop, traumatic injury needs to occur, as trauma to the ankle joint is the root cause of 85 percent of cases. The most common trauma resulting in an osteochondral lesion is a severe ankle sprain. Symptoms of an osteochondral lesion include:
- Pain
- Swelling
- Ankle instability
- Ankle catching or locking up
Injuries to the talus can be a little more difficult to manage than injuries to other parts of the ankle, simply because the talus does not get a great blood supply. This can inhibit healing and lead to prolonged symptoms, so proactive treatment is recommended.
Diagnosing and Treating Osteochondral Lesions
These types of injuries are pretty easy to diagnose, especially if you’re experiencing the locking up or freezing of the joint. This will give the foot specialist a good idea of what you might be dealing with, but they’ll confirm their suspicions by conducting a physical exam and imaging tests. X-rays do a pretty good job of pinpointing an osteochondral lesion, but in some cases, a CT scan or MRI may provide the best picture.
Treatment can involve conservative or operative options, but your doctor will most likely have you start with non-operative care. Conservative care tends to involve immobilization and limited weight bearing, followed by a gradual progression of weight bearing and physical therapy. The goal here is to provide the cartilage and bone with enough stress-free time to heal, and then to strengthen the area with physical therapy.
If conservative care fails or you have a more severe lesion, surgery may be recommended. The main goal of surgery is to restore the natural shape and gliding surface of the talus so that movement is smooth and there is no locking. This can also help to prevent or limit the eventual onset of arthritis. Surgery is usually performed arthroscopically, and may also involve debridement of loose bone and cartilage, fracture fixation or even bone grafting in serious cases. Your surgeon can walk you through the specifics should surgery be necessary.
So if your ankle is locking up or freezing, don’t just hope it will go away on its own. Reach out to an orthopedic specialist in your area, and get the proactive treatment you need to take care of the problem once and for all.