The talus bone is a large bone at the back of the foot, also referred to as the anklebone. It is cushioned on top where it meets the shinbone by a layer of articular cartilage. Articular cartilage is the white, slippery material that covers the surfaces of all joints. When the ankle is severely sprained, the talus bone may be chipped. This cracks or breaks the articular cartilage and may form cysts in the talus bone. This condition is known as Talar OCD, or an osteochondral lesion of the talus. While initial symptoms may be similar to a sprained ankle, persistent pain, swelling, and a catching sensation while using the ankle may indicate this more serious condition. Surgery is usually required to repair Talar OCD.
For less severe injuries, Dr. Shani performs an arthroscopic technique of surgery to treat Talar OCD. In this procedure, Dr. Shani makes small incisions around the ankle for minimally invasive surgery using miniature medical instruments. Dr. Shani removes or repairs damaged articular cartilage and removes bone cysts that have formed. This allows the talus bone to move normally and eliminates immobility, pain, and swelling. In more advanced cases of Talar OCD, an open surgery is required where bone grafts with healthy cartilage are positioned to replace the damaged top of talus bone. Depending of the severity of the injury, the surgery may require a bone allograft (from a donor) or bone autograft (from the patient’s body) to replace the damaged portion of talus bone. Dr. Shani will discuss with patients the best surgical procedure based on the severity of the Talar OCD.
Dr. Shani and a physical therapist work with patients for about six months on a personalized rehabilitation program to get patients back to sporting as quickly as possible. After surgery, the ankle is kept immobilized for about one week. After one month, physical therapy focuses on range on motion exercise to regain strength and mobility. By the third month, physical therapy progresses to increased ankle strengthening exercises and sport specific training. Most patients can return to pre-injury level of play and ability after six months of physical therapy and consultations with Dr. Shani.
