Ankle Osteochondral Defect (OCD) anyone?

Hi Drew,

Curious as to which option you chose and how your recovery has been. Any insight would be helpful.

Thanks!

Hi

Just wondered how your ankle is doing. I have a stage 1 also and have been on crutches for 5 weeks

I know this thread is old...but I am in the same boat as you were a few years ago. Curious to know how things worked out for you.

I had a OCD in my talar dome caused by a rock climbing incident (so was caused on impact)

Spent 9 weeks non-weight bearing in a boot, relgliously did my physio. 3 years later I still rock climbing (and fall on it!) and run 40p mpw with minimal pain (sometimes a bit stiff)

Not sure about future consequences but will deal with it later!

Hi,

I also have an OCD on my talus bone, 4 weeks post microfravture surgery. I’m curious, what type of surgery did you have, if any, and how big was your lesion?

Thanks

Anne

I am a marathon runner that was just diagnosed with a 7mm by 8mm osteochondral medial talar dome fracture. I ran Boston 2018 in sub 3 and was fine. The "pain" and weirdness only started as I have resumed running post-marathon. I had images last week when the swelling wouldn't go down after 2.5 weeks. The foot orthopedic that I saw today essentially said that it won't heal itself and that I need surgery. I planned on running Berlin in September which is clearly out if I get surgery. I also have a marathon in December. He didn't think either were doable. The funky thing is that it isn't super painful. Doesn't hurt to walk. It's just cob webby for the first few minutes of the run and stiff and swollen. I'm not sure what to do. The pictures say enough, but I'm not sure how long it's taken for the lesion to form. I'm not sure what to do. Does anyone know what the quickest possible timeline could be (assuming I even fit in that category).

Sounds like you're doing fine - why is the doctor recommending surgery?

I'm 57 and have a 9mm x 11mm OCD on the talus and a secondary finding of PTTD/grade 4. I can barely muster 15 mpw (only 3 days a week) and a few miles of speedwork. The ankle is swollen all the time and I walk with a limp after running most days. Lots of ice treatments, spin biking, eccentric heel lifts, one leg balance exercises & glucosamine. Pain can be pretty bad on some days - thank you pain meds.

Only surgery recommended for me is primitive ankle fusion which wouldn't allow any running whatsoever. I'd give any anything to be in your shoes! (no pun intended).

I've ever had, but they are qualitatively the most comfortable walking shoe I've ever put my feet into. The shoes were true to size, and were "out of the box" comfortable the first time I put them on. I've experienced such intense foot pain that in the past I had to curtail my gardening activities. orthofeet shoes have given me back my gardening life. I can now stand again for hours without discomfort. I would definitely buy these shoes again.

Can you share the name of the shoe brand?

So what did you finally decide? Did you run Berlin? Did you get surgery? Please update us.

hey, I am a 16-year-old high school runner and I was just diagnosed with OCD in both ankles. I am taking a 6-week break total with a cast for each ankle for 3 weeks. I was wondering how your non-surgical approach worked out.

Thanks so much if you answer

Sorry for the late reply. I ended up resuming running really carefully and slowly after the THIRD orthopedic (we went up to Duke for the third opinion per a doctor recommendation at Mayo Clinic) said that we should try x, y, and z before surgery. He thought it was something I had possibly developed a very long time ago and it wasn't something new. Said I was too asymptomatic to resort to surgery so early on. He also reiterated that the lesion wasn't going to get a lot bigger with more running. After some run/walking and grass running, I got onto the roads and was pain free. Ended up developing some insertional Achilles tendonitis in the left foot (probably from compensating somehow for the right ankle) at the end of July which kept me out for ~10 days. That put Berlin out of the question for sure. I just didn't see how forcing a marathon would help my cause at all; it would just make me really anxious and worried. Since resuming running after the Achilles scare, I have had an excellent and entirely pain free buildup for CIM and have averaged about 75-80 mpw. I have also PRed in three distances this fall. Thank God for the doctor at Duke who clearly knew what he was talking about...Further reason to get multiple opinions!

I fractured my talus in 2008 + multiple severed ligaments, split of peroneus brevis and peroneus longus. Surgery in 2009 to repair soft tissues and microfracturing of talar dome (my lesion was 6mm X 1cm) and wore a boot for 1.5 pre-op (walking) and 8mo post-op without ground contact.

I was an avid runner, triathlete, and soccer player prior to injury. Have not been able to return to running since. I originally tried 2-3 year post-op but ankle instability and the jarring motion of running really hurts, almost like bone-on-bone pain.

Have had subsequent twists and sprains but nothing requiring surgery.

I can use an elliptical and walk on a treadmill— but hiking or biking with clips is impossible to enjoy due to lack of movement in my ankle (my calf muscles on injured side are 2” smaller in diameter— just can’t bend my ankle/leg to use ‘em!)

I know this an old thread, but always like to hear other people’s stories. Has anyone had a microfracturing years ago and had a new surgery with bio-cartilage or transplant?

I would LOVE to run again— just cannot do it with the current biomechanics. I’d push through and reinjure if there was a better fix available; but it doesn’t seem to be the case. Quite the bummer! Hope everyone out there is healing up and can keep on moving forward.

Hello. I was just informed by my OS that I would have to undergo OATS for my ankle but that this procedure is not usually covered by insurance. Has anyone else had this procedure and was it covered by insurance?

I found out I had OCD of the Talus back in 2008. Was never sure what caused it. I was hiking in the woods on soft leaves and all of a sudden I couldnt walk on my right foot without severe pain. Ended up up with a surgeon that had done several of the procedures before....that was rare at that time. Went for a second and third opinion and both surgeons begged me to do it but had never done it before so I went with the first guy. Boston...Czarenecki

He used a donor bone and cored my Talus like an apple to remove the lesion which they said was large. Then they plugged that hole with the donor bone. Slow recovery. 2 years later moved into a new apartment and I guess I did too much heavy lifting and stairs.....I felt as if I had crushed it. It felt like I was standing on a nail that was hammered up into my ankle it was horrendous. Not a single doctor in the whole wide world would give me any pain meds that would come even close to dulling the pain. This lasted 6 years!!! I begged for pain meds and after the first year finally started begging for a wheel chair instead. Anything to get rid of the pain. I got a power wheel chair. Don't wish it on anyone. I could stand and walk for about 10-15 minutes without pain. I could only do that maybe once or twice a day. Had pitting edema in that lower leg the whole time. Life stops unless you can afford a $70,000 wheel chair van. So my life stopped.

3 years ago I got medical marijuana for anxiety. I eventually noticed that I could stand in the kitchen longer than usual. My pain had stopped. I couldn't believe it. The swelling and pitting edema stopped too. At the same time I started the medical marijuana I also got special sneakers at the podiatrist due to diabetes. Brand is APEX. OMG, miracle sneakers. I had constant plantar fasciitis after the ankle surgery as well. I highly recommend these shoes I haven't had any pain what so ever in 3 years now and never got plantar fasciitis again. . I haven't had to use my power wheel chair in 3 years now. I stand and walk around like I have no issues. Heck I have gained 150 lbs in the last 10 years since the surgery and being in the wheel chair and all but for some odd reason I have my foot back. Now I can lose the weight.

There have been studies that show that marijuana increases the speed in which bones heal. OR the medical marijuana is masking the pain receptors. I believe it helped and continues to help me.

At one point I was begging them for amputation. Never thought I would get better. Wanted a bionic foot. Good luck everyone and hope you heal faster and better than I did.

My story if anyone is interested. Diagnosed with 1cm by 1cm OCD, pretty bad according to the surgeon. Family sure I did it with a really minor ankle strain / chronic injury. It was so bad I could barely walk after running / playing squash. It was even interfering with my ability to walk to work so I stopped exercising. If I jumped up and down it would crack like I was snapping the bone in half. I never had the chance to rest it until the Covid lockdown.

After 12 months of rest I thought I would try graded exercise, including running, weights, interval training. It was really sore for the first month. I stuck with it and built up strength and intensity. 6 months on I am playing squash and running again. Interestingly the ankle cracking has also stopped, I assume due to breaking down scar tissue or cartilage floating around.

However the squash is really the issue with twisting and turning - that really triggers the pain but it's tolerable. Overall I think with my outcome it was the right decision to avoid surgery. Everything but squash is now unhindered bar minor pain and stiffness. I would expect that a medial talar dome OCD is a career ending injury for anyone who takes a dynamic sport seriously.

To offer some ray of hope, I know that a lot of footballers have this injury and are never diagnosed until there is an incidental finding on a scan. It seems some people get by with minimal issues or make nearly fill recoveries.

Happy to share my workout plan if anyone is interested in what worked for a fairly bad case.

My Rehab So Far

I am 50 year old, and got an osteochondral lesion on talus dome (about 1.3cm in size) six year ago. This year, the symptom got worse and I can’t manage anymore, so I decided to do an ankle arthroscopy with debridement and microfracture in the end of July 2021.

Rehab timeline:

First of all, rehab is a long journey, way longer than I thought. It can be very emotional. There are ups and downs.

Started swimming at the beginning of week 3 (4 times a week) and continue through rehab.

Tried partial weight bearing at full 6 weeks, however ankle feels weak, so partial weight bearing actually started at full 7 weeks. See PT, but he suggested simple exercises only. No much you can do without weight bearing.

Week 8 - Week 10 (3 weeks) increased partial weight bearing. Start biking at the beginning of week 10 (3-4 times a week).

Week 11, started full weight bearing, ankle feels weak and can’t walk much (maybe 100/200 yards) with full weight bearing. In the middle of week 11, maybe I pushed too hard on biking. Started feeling sharp pain when walking after biking. Not very sure it is because of biking. This is a major setback, I have to rest, ice, elevate for 3 days to go back close to pre-setback.

Any new update?

Hi All. Looking for insights from this group. I've had a grade III talar dome OCD for > 10 yrs. Pain has been manageable but I've been living a restricted life and babying the ankle; no running, jumping, or uneven surfaces. Ankle instability has increased and I recently had a bad fall (concussion, fractured nose, knee and shoulder injuries) that resulted in a fragment breaking off, an increase in pain and instability. I'm seeking surgery now more due to fear around instability rather than pain. My surgeon is Dr. Pedowitz at Rothman in Philly. He's using a BMAC/cadaver cartilage paste and creating a biosandwich with that and a calcaneal graft over the debrided OCD via arthroscopy. I'm told NWB x 6 wks post op with first 2 wks in a half plaster cast, 4 more weeks in a boot. PT should start at 6 wks post op. Not sure how long before I get to lose the boot and go to a brace, I'm told it depends on me and my pain/healing via PT.
Who has had this procedure and/or been a patient of Dr. Pedowitz?