Persistent Pain After Ankle Sprain – Think of Talus OCL


Inversion sprain of the ankle joint is very common.  Most of the time the pain resolves and one can resume normal sporting activities.

However, in some people. the pain may not totally go away.

There are 2 common causes of persistent pain that just simply won’t go away after an ankle inversion sprain.  The first is formation of scar tissue inside the ankle joint.  The other is an osteochondral lesion of the talar dome.

For example, this sportsman presented with persistent pain in the anteromedial aspect of his right ankle after an inversion sprain which happened 4 months ago.

X-ray of the right ankle appeared normal.

MRI scan showed an osteochondral lesion involving the superomedial aspect of the talar dome.

Superomedial Talar Dome Osteochondral Lesion

This diagnosis would have been missed if not for a high index of suspicion and by the use of an MRI scan.

Treatment consisted of an arthroscopic excision of the talar dome osteochondral lesion together with microfracture of the bony base to stimulate fibrocartilage formation.

Ankle Arthroscopy for Talar Dome Osteochondral Lesion

Ankle Arthroscopy with Microfracture of Talar Dome Bony Defect

Video of the right ankle arthroscopy.

Part 1 – Probing the Lesion

Part 2 – Debriding the osteochondral lesion

Part 3 – Microfracture of the Bony Defect

Post-operative rehabilitation involves 6 weeks of non-weight bearing ambulation of the operated leg with help of crutches.

The patient is required to do active range of motion exercises of the ankle to promote the formation of fibrocartilage.

For more information, please contact us at 683 666 36 or email hcchang@ortho.com.sg.

Visit us at www.ortho.com.sg

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