CONTACT US

Pain After Sprains: Osteochondral Lesions

Osteochondral lesions are tears in ankle cartilage caused by trauma to the joint.

If you’ve recovered from an ankle sprain or fracture and still feel pain in the joint, you may have an osteochondral lesion.

Osteochondral lesions often go undiscovered during an evaluation for ankle trauma since they develop over time. They can be painful and reduce mobility in the joint, making it difficult to participate in sports or other activities.

Think you may have an osteochondral lesion? Read more about this condition and possible treatment methods below!

Treating Osteochondral Lesions

What is an osteochondral lesion?

An osteochondral lesion is an injury of the cartilage, or the connective tissue on the bones between joints, typically after an ankle sprain. 

The cartilage may be torn, crushed, or, in rare cases, a cyst may form in the cartilage. Cysts are caused by a break in the bone that allows fluid from the joint to leak into the cartilage.

Osteochondral lesions often occur in the talus bone, which is the bone that connects the heel bone to the tibia and fibula of the leg. They also commonly occur in the second metatarsal of the foot.

Causes of Osteochondral Lesions

Ankle sprains and fractures may lead to osteochondral lesions. The trauma to the joint causes the cartilage to weaken and eventually break off. The cartilage may remain in the ankle, creating a severe case of an osteochondral lesion that can cause damage to the bone.

It may take months or years after an injury for an osteochondral lesion to develop in the foot and ankle unless the injury is severe.

Younger people, especially athletes, tend to get osteochondral lesions because they participate in highly-active sports and activities that stress the ankle joint. Children also may get osteochondral lesions due to abnormal bone development.

Symptoms

An osteochondral lesion is usually accompanied by pain. It may feel like a dull ache in the joint and worsens with physical activity.

Other symptoms of an osteochondral lesion include:

  • Locking or clicking of the joint
  • Swelling
  • A sense of looseness in the joint

If left untreated, pain will increase and range of motion in the joint may eventually become limited as the osteochondral lesion develops.

Diagnosis

If pain occurs after a sprain or fracture has healed, then an osteochondral lesion may be suspected. If you believe you may have an osteochondral lesion from an ankle joint injury, schedule an appointment at Frankel Foot & Ankle to prevent it from developing.

Dr. Frankel will examine the ankle and foot by assessing range of motion, pain levels, and any indication of swelling or looseness.

An X-ray or MRI may also be necessary to properly diagnose an osteochondral lesion in the talus or second metatarsal.

Treatment

Osteochondral lesions can be treated without surgery, especially in children. Adults may require surgery depending on the size, location, and severity of the osteochondral lesion. Your podiatrist will determine if you qualify for surgery after a consultation.

Nonsurgical treatment options include:

  • Rest from physical activity and sports
  • An ankle brace to stabilize the joint and allow the cartilage to heal
  • Anti-inflammatory drugs, such as ibuprofen, to reduce inflammation and relieve pain
  • Immobilization with a cast to further stabilize the joint in more severe cases
  • Physical therapy to strengthen the muscles, cartilage, and bone in the joint and improve mobility

Another treatment option that will speed up the healing process and restore the functionality of the joint is a platelet rich plasma, or PRP, injection. This is a natural method of regenerative medicine that rejuvenates the healing process in the cartilage.

If osteochondral lesion surgery is necessary in severe cases, then the damaged cartilage of the ankle can be replaced with an allograft of juvenile cartilage tissue. The benefit of replacing the damaged cartilage with an allograft is that the cartilage will fully repair the cartilage with healing cells called chondrocytes.

An allograft will restore the cartilage and return the joint to full functionality and mobility.

Prevention

Preventing an osteochondral lesion can be difficult since it is normally caused by an acute joint injury that is the result of miss-stepping or an accident. However, there are a few precautions you can take to help prevent sprains, fractures, and stress to the joints.

  • Mobility exercises: Participating in exercises that strengthen the muscles and bones will protect cartilage from weakness and tearing.
  • Adequate rest: You can prevent osteochondral lesions by resting between workouts and allowing the muscles and bones to recuperate after sports events.
  • Supplementation: Supplementing with vitamins and minerals, particularly vitamin D and calcium, will strengthen your bones and decrease the likelihood of an osteochondral lesion.
  • Check-up after an injury: If you have an ankle sprain or fracture, ask your podiatrist if there is a possibility of an osteochondral lesion for early detection.

With the tips above, you can protect your joints from fractures and sprains that can lead to a painful osteochondral lesion.

Receive treatment for osteochondral lesions today.

Schedule a consultation with Dr. Frankel at Frankel Foot & Ankle to determine the right treatment method for you.

Heal osteochondral lesion pain with Dr. Frankel.

Dr. Frankel founded Frankel Foot & Ankle to provide patients in Pennsylvania, New York, and New Jersey tri-state area with the latest advances in diagnostic technology and treatment for sports medicine conditions, foot and ankle trauma response, and innovative surgical and regenerative approaches. Contact Frankel Foot & Ankle today.