I have now said ENOUGH! • Verhagen et al. Sanders TG, Paruchuri NB, Zlatkin MB. fractures involving a single facial buttress, Meyers and McKeevers classification (anterior cruciate ligament avulsion fracture), Watson-Jones classification (tibial tuberosity avulsion fracture), Nunley-Vertullo classification (Lisfranc injury), pelvis and lower limb fractures by region. Osteochondritis dissecans, unspecified ankle and joints of foot. Shell osteochondral allografts of the knee: comparison of mr imaging findings and immunologic responses. This is essential in determining management. My 10 year old daughter has been NWB and in a boot for 3 months, then 4 months no impact and the recent MRI is almost identical to the one 7 months ago (no better, no worse, stable lesion), Your email address will not be published. Your surgeon should be in the best position to give you good advice on how to proceed. Guttentag is a real jerk. Surgery is often needed to better assess the lesion and determine the goal of either lesion healing or removal. In general talus OCD is difficult to get healed with or without surgery. I had my X-Rays and the doctor said that there is nothing on my foot. It would have saved me a lot of frustration and worry! She will use an electrical bone stimulator during this time as well. An OCD lesion of the ankle is a specific type of injury to the bottom bone in the ankle joint. My daughter is having the same issue, I have bilateral OCD of the ankle, my first visit with the surgeon is this week. Dr. Ebraheim’s educational animated video describes Osteochondral Lesions of the Talus. Beverly, i also have OCD. tomorrow with Dr. Pedowitz for my follow up after my CT Scan to talk surgery for my OCD and hardware removal from a trimalleolar fracture 6 years ago. Thank you. Osteochondral allograft or autograft which is performed on large lesions is a procedure which is either done with using another piece of bone to fill in the lesion. The talar body has a curved smooth trochlear surface also termed the talar dome, which is covered with hyaline cartilage and convex from front to back. A history of locking, catching or ankle sprains on multiple occasions is common. Fifty ankles in 50 patients treated with arthroscopic bone marrow stimulation techniques for an osteochondral lesion of the talus (<150 mm 2) were evaluated for prognostic factors.The patients were 22 men and 28 women (mean age, 35.0 years). Personally, I would like to go ahead and get both ankles replaced, but the doctor is saying that the longevity of the replacements are not known past 15 years. Osteochondritis dissecans (OCD) most commonly affects the knee. anterior aspect of lateral femoral chondyle and posterolateral tibial plateau When planning the treatment of osteochondral lesions of the talus, it is important to evaluate the articular cartilage to distinguish between stable and unstable lesions (1,2). They had me to go back to work. I an blue on the foot it’s swollen worse and the antiflamator meds meloxicam is a dangerous med I won’t take. [box type=”note”]Roger M. Lyon, MD. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. (2020) Skeletal Radiology. Presentely i m bearing t pain without painkiller.Doctor r recommending for Arthroscopy. Although the exact cause of osteochondritis dissecans is unknown, there are several factors such as high demand impact sports, underlying disease conditions, local bone blood flow and genetic factors. 1. repetitive throwing / valgus stress and gymnastics / weight bearing on upper extremity 1.1. valgus stress / compressive force on the vulnerable chondroepiphysis of the radiocapitellar joint in skeletally immature patients is supported as the etiology for OCD of the capitellum 8 2. ankle sprain/instability 2.1. 1/14/2020. 6. I wish you and your daughter the best in dealing with this situation. Should we consider surgery or continue the conservative treatment? I have had surgery for ocd of my R ankle. Sounded just horrific so I am hoping for a really high I am sorry to hear about your son. I intend to see another doctor, but until then possibly you can give me hope as the OCD sounds to be dead on. If the surgical treatment is well matched to the specifics of the lesion the success can be around 80 to 90%. Surgical intervention itself is not always successful, but with the appropriate intra-operative algorithm and a conservative post-operative plan, many children can avoid a second surgery. Unfortunately the pain has become unbearable and I am now facing surgery. Sorry to hear about your situation. Your doctor will also check other structures around the joint, such as the ligaments.Your doctor will also ask you to move your joint in different directions to see whether the joint can move smoothly through its normal range of motion. AJR Am J Roentgenol. Does anyone know what the success rate is for microfracture surgery for OCD of talus? All my reading suggests at 42 yes old there is little hope of a pain free life. I am 28 years old. Drilling is also an arthroscopic procedure to promote stimulation of the underlying bone. As a child I had lots of ankle problems they tried to correct it with first a brace, then a boot, then a cast, and finally I had surgery around 12 years old, I remember being told that the surgery could fix it forever or it could come back as an adult and I may have to have the surgery again. Do you think sugry is a good idea? Introduction: Spectrum of disease entities from single, focal defects to advanced degenerative disease of articular (hyaline) cartilage; Epidemiology. Sheila Felix. Deborah, My wonder is is this condition covered under SSID because the recovery time alone is longer than my FMLA. Osteochondraldefect is a broad term that describes the morphological change of a localized gap in the articular cartilage and subchondral bone 5. same mechanism of injury as OCD. Radiography cannot directly depict the cartilage surface (3). Hang in there if you are in it! I’m sorry if you’ve already mentioned this, but where can I find ROCK doctors that you speak of. Check for errors and try again. I am having pain if I am setting more that if I am walking and when I am standing which I dont know why. Can anyone share their experiences on this surgery. About 4 years ago the pain started up again. I had an old injury to my ankle that never really healed well and then in 2012 I twisted it rather severely. They also have some offices in New Jersey. I am very grateful I opted for that because I think my outcome has been better, but initially I had a great deal more pain. I am a jumper and on my last year of track. I’m a 20 year old collegiate track and field athlete and I was just diagnosed with OCD this past fall. There is an increasing prevalence of this condition in athletic teenage girls. These techniques would also be applied to defects that are larger than 5mm2 . The findings from the MRI he did this summer says “A 1.2 x 0.9 x 0.6 cm osteochondral lesion is seen involving the medial talar dome with mild thinning of the underlying cartilage and slight adjacent bone marrow edema.” After more than 3 months of physical therapy we did see some improvements, but the pain didn’t completely gone. The cause of osteochondritis dissecans is not fully understood. 5. Ron, Thank you for your input. Surgical options in your case may include lesion removal and/or tissue replacement. Panner's disease (osteochondrosis of the capitellum) typically presents in first decade of life (<10 years old) usually benign self-limiting course. talar body fractures . following anterior cruciate ligament repair), femoral condyle (most common in the lateral aspect of the medial femoral condyle), the signal is variable with intermediate to low signal adjacent to fragment and variable fragment signal, low signal loose bodies, outlined by high signal fluid, donor defect filled with high signal fluid. It is often used synonymously with osteochondral injury/defect and in the pediatric population. Maybe because of the weather!! Occasionally bone grafting is indicated in unstable lesions that do not have significant joint congruity to allow restoration of articular congruency and enhance the healing potential. If the fixation of the lesion is not possible and the lesion needs to be debrided there are several salvage techniques for full thickness defects including marrow stimulation techniques (ie micro fracture), autogulous chondrocyte implantation, osteochondral autograft transplantation and osteochondral allograft transplantation. However, in early stages, the cartilage layer is intact, and the lesions may not be seen at arthroscopy. Your comment is the only legit result when searching for osteochondrosis and amputation. He is suggesting an allograft procedure instead. Oblique and plantar flexion radiographs of the right ankle generally will improve the visualization of the osteochondral lesions often because they are in the posterior aspect of the talus. Do you feel there is potential for her lesion to resolve in this period of time? This procedure requires the fresh graft to be obtained by a donor and once graft is obtained needs to be done on “urgent” basis; usually within 10 days while the graft is still “fresh”. I have been dealing with this for close to 7 months. These authors evaluate the effectiveness of procedures such as microfracture and arthroscopy, and recent innovations such as juvenile particulate chondrocyte allografts. This can result in detachment of the softened bone and cartilage leaving a crater in the bone that is exposed to the joint surface and a loose fragment within the joint. Good Luck. Hello, Sandy, If the lesion is unstable or hinged, fixation is often indicated in an attempt to heal the lesion back to native bone. The treatment options depend on the skeletal maturity of the patient, size and stability of the lesion as well as the location of the lesion within the bone. But now my left foot is hurting the same pain is it possible to have the same injury on both feet? Non operative treatment usually requires the patient to be nonweightbearing for a minimum of 6 weeks with activity restrictions and the use of a cast and/or brace. During the physical exam, your doctor will press on the affected joint, checking for areas of swelling or tenderness. incidence 69% of ankle fractures; 70% of ankle sprains; 10% are bilateral I had to see the doctor again and I got my MRI done in October 2015. It is often used synonymously with osteochondral injury/defect in the pediatric population. Both magnetic resonance (MR) imaging and ankle arthroscopy are excellent tools commonly used to evaluate ankle cartilage (3–5). Thank you, Hello, The most commonly used system for classifying OCD lesions was presented by Berndt and Harty in 1959, with additional staging described by Scranton and McDermott in 2001. He injected it I felt the stab stab and then it was like two bags he went through the pain was horrible and I have had 5 kids pain meds free. About 8 weeks later I was diagnosed with OCD. He also said that if I still have pain, it’s better to do Ankle arthroscopy. MRI is the single best study for both the diagnosis and prognosis of the osteochondritis dissecans lesion of the talus. The osteochondritis dissecans lesion is an area of the bone within a joint that has deterioration and softening and subsequent overlying cartilage damage. Chronic repetitive micro trauma may lead to stress within the subchondral bone which results in bone necrosis, softening, desiccation and separation. Therefore, the treatment algorithms are also similar. Most of these operative treatments are performed as an arthroscopic outpatient procedure. Finally last year I went in to see the doctor. If they are not able to provide the needed answers/recommendations then face to face consultation with one of the specialists at a ROCK site may be helpful. Many cases of ankle OCD are difficult to fully resolve and some will need more than one surgery. When initially assessing a child with evidence of this pathologic process, one should first consider the skeletal maturity. incidence. thank you for your useful discussion. I had to see the doctor again and I got my MRI done in October 2015. Well, the pain right now is not that bad as it used to be in October 2015 through April 2016. Sparing the blood supply. OCD can run in families, but often it does not. Osteochondritis dissecans of the ankle tends to have a low level of chronic persistent pain, a variable amount of swelling which is often intermittent and not severe. I was given 3 steroid injections later Underwent Microfracture surgery which didnot help me. Osteochondritis Dissecans is an acquired joint defect which involves the subchondral bone and the overlying articular cartilage. if the lesion has not healed and is still painful it may need further surgery. Workers comp doc said I have ocd in January 2016 they put me in a cast 6 days Some days are mine, some days I feel too much pain. Is this jerk for real? there was also no OATS done. As an orthopaedic surgeon specializing in treating OCD lesions in children, not all treatments are 100% successful. Hi, I cannot find a code for the open approach to micro drilling of the OCD of a talus without any grafting done. Onset is between childhood and middle age, with the majority of patients being between 10 and 40 years of age, with approximately a 2:1 male to female ratio 3. Osteochronditis dissecans (aka “OCD”) is a condition in which the bone that supports the cartilage inside a joint undergoes softening. I have the pain in my left ankle since April 2015. ADVERTISEMENT: Supporters see fewer/no ads. Few months later, The pain was horrible while I felt pain in my whole foot and my leg, as well in my two big toes are beeing numb. Osteochondritis dissecans can often be a progressive pathologic process: evolving to joint deformity and occasionally bone and cartilage fragmentation to intra-articular cartilage instability. Arthroscopy can be useful to check the posterior subtalar joint, to which access is limited. Conservative treatment of osteochondral lesions of the talus (OLTs) should be attempted first, whenever possible. Routine x-rays of the ankle can easily miss a small osteochondritis dissecans lesion, so it often goes undiagnosed for a long period of time. Systematic review of treatment strategies for osteochondral defects of the talar dome. I was diagnosed with OCD. i hope to be healthy, I have had 4 surgeries for my right ankle OCD and now no other option but a total ankle replacement. Pediatric Orthopaedic Society of North America (POSNA) 1 Tower Ln, Suite 2410 Oakbrook Terrace, IL 60181 p: (630) 478-0480 f: (630) 478-0481 e: firstname.lastname@example.org Maybe because of the weather!! Any recommendations concerning new treatment needs to be based on what a new evaluation shows. Do you have any suggestions on how I can still finish my senior season? Dr Lyon, 2006;187 (5): 1332-7. W B Saunders Co. (2001) ISBN:0721690270. While the recovery time with an arthroscopy was much shorter I did see in my research that the larger lesions responded better to mosaicplasty so I opted for that procedure. (2018) Radiographics : a review publication of the Radiological Society of North America, Inc. 38 (5): 1478-1495. To demonstrate talar neck - place ankle in equinus, place foot on cassette and pronate 15°, x-ray tube is directed cephalad at a 75° from the horizontal. Good Luck with your situation. OCD lesions account for about 1% of all talar fractures. There is not a limit to the number of operations but any operation needs to fully address the core problem to get to a solution. Your surgeon would be the best person to address these issue and questions you bring up. Medical College of Wisconsin[/box], Dr. Ben Heyworth is an Orthopedic Surgeon specializing in Orthopedic Surgery,
Every situation is different and I don’t know enough about your case to give you an opinion. The workers comp doctor was more involved in if I liked my job and if I was fired. Most cases of osteochondritis dissecans of the talus occur around the time of skeletal maturity (10-14 years of age for girls and 12-16 years of age for boys). Occasionally other studies may be helpful such as a computed tomography (CT scan) to further define the anatomy of the lesion and occasionally a bone scan is helpful to judge the ability of the lesion to heal and help manage a treatment protocol. Children can normally return to sports after 2 to 4 months. What is your opinion on replacement surgeries? However, I really love to jump and want to finish my last year as well as possible. The lesion on her talus is roughly 1 cm in size and she is experiencing significant pain when weightbearing. Sincerely I have a boot but I refuse to work cause they won’t leave me alone on lite duty which to them is running all over the store and run a cash register. MRI is the modality of choice, with high sensitivity and specificity for the detection of separation of the osteochondral fragment (see: osteochondral injury staging and osteochondritis dissecans surgical staging). Unless the injury is extensive, it may take months, a year or even longer for symptoms to develop. These are typically monitored by interval radiographs and occasional use repeat MRIs. • von Knoch F et al. I am 20 yrs old now and in the same situation. I am 51 years old, I did the 2 months with no wt bearing then minimal. This seems odd to me because CPT assistant says "Clinical Example (28446) The patient has a symptomatic osteochondritis dissecans lesion of the talus, and the usual arthroscopic or open debridement and drilling have failed." any advice. besides gg for operation, are there any other non operative method ? It has been 21 years since my surgery and I have had no problems up until a year ago. 5-10% of people > 40 years old have high grade chondral lesions; location. Curruently I am not taking any medicine. How many months does it take to see healing on an MRI generally? Finally had surgery 3 months ago, as have now the pain is just unbearable so far two cortisone shot and physical therapy. Rothmans is number 1 in the US for joint replacement. Well, the pain right now is not that bad as it used to be in October 2015 through April 2016. focal injuries to the talar dome with variable involvement of the subchondral bone and cartilage resulting in osteochondral lesion of the talus (OLT) may be caused by traumatic event or result of repetitive microtrauma; Epidemiology . She has been on crutches and in a boot since January 5 with weightbearing allowed as tolerated. Along with the tibia and fibula (shin bones) this forms the ankle joint. surgery is contraindicated for Panner disease (unlike OCD elbow) Prognosis. Good luck to you and your son. I dont want to go for surgical treatment.My doubt is shall i try Acupuncture,Homeopathy,Reki etc and go on trying non surgical ways or straight way go for surgery?–S Malu, Hello, Pediatric Orthopedics, Sports Medicine, Adolescent And Young Adult Hips, General Orthopedic Surgery, Pediatric Orthopedics, Sports Medicine, Trauma and Overuse Injuries. It does behoove the treating physician to remain persistent in the treatment plan and for the child and parents to remain patient with the often slow healing process. Rothman has several ankle doctors, however, i would recommend Dr. Pedowitz. The talus has been described as having three main components: head, neck, and body. Thanks I’m trying to make a decision whether or not to have surgery done on my 15-year old son’s right ankle. i myself am a patient and will have my right ankle operated a week later. How many surgeries can the talus go through? Increased incidence of osteochondritis dissecans in the ankle is seen in developing bone and joints that are subject to large amounts of physical activity. Cortisone shot,brace and boot did not work. The goal of non-operative treatment is to promote healing in the subchondral bone and prevent chondral collapse, subsequent fracture and significant crater formation. But it is a hard journey through the healing process!! The surgeon told me that it had developed from a bone cyst from an old injury because my lesion was 8mm x 11mm. chronic ACL tear. Do you think sugry is a good idea? Fresh osteochondral allograft is a procedure which is done on very large lesions. © 2018 Osteochondritis Dissecans | Site by Yakadanda, Research in Osteochondritis of the Knee OCD Study Group of America. Osteochondritis dissecans (OCD or OD) is a joint disorder primarily of the subchondral bone in which cracks form in the articular cartilage and the underlying subchondral bone. Glossary of terms for musculoskeletal radiology. He also said that if I still have pain, it’s better to do Ankle arthroscopy. I have an appt. I am sorry you are suffering from your talus OCD lesion. In some cases, you or your doctor will be able to feel a loose fragment inside your joint. Osteochondral defect is a broad term that describes the morphological change of a localized gap in the articular cartilage and subchondral bone 5. My question is how could I treat injury to avoid surgery, by the way I tried Accupuncture to see if it will help keep the swollen down. Curruently I am not taking any medicine. The surgery may have been 17 years ago but I remember a little and what I remember is that they went in there to replace or repair some cartilage between two bones that were rubbing together that shouldn’t have been and that’s what was causing my pain, my constant twisting my ankle, and falls because my ankle would go out on me. Thank you! In young children, OCD normally heals with rest, as the bones are still growing. Please address this with your surgeon because they know your situation best. no surgeries yet. He sent me back to work full duty and physical therapy 4 days a week 4 weeks total and lift 15 lbs with foot every day Operative treatment also provides the benefit of a more dynamic assessment of the lesion and the severity of lesion instability and assessment of injury to the overlying cartilage. I was diagnosed with OCD in both of my ankles, when I was 11 years old. Same here, 14 yrs, 5 surgeries Inc microfracture, it just gets worse, (last op 3x worse!) Options for procedures are determined by the size and location of the lesion and also several patient characteristics. Am J Sports Med 2005; 33(6): 871- 880. As mentioned above, there are many back-up plans that can be undertaken given each child’s individual needs. Fracture of the lateral process of the talus in snowboarders. Some days are mine, some days I feel too much pain. The right ankle appears to be much better, but the left ankle has had two surgeries and it hurts so terribly bad. However, they are insensitive to grading lower stage lesions and are inadequate in predicting stability. 22 (4): 765-74. Initial treatment has traditionally been non-operative. Debridement of the lesion is an operative procedure which removes the dead (necrotic) to promote healing stimulation of the lesion and underlying bone. This is not an uncommon situation. Operative treatment is the treatment of choice for patients with unstable or detached lesions or failed non-operative management and for patients that are at or past skeletal maturity. The osteochondritis dissecans lesion is an area of the bone within a joint that has deterioration and softening and subsequent overlying cartilage damage. If you need another opinion one of the the ROCK members could either see you or at least get you to someone that could give some good advice. Charles, Treatment principles of osteochondral lesions of the ta… They did xrays and an MRI and concluded my pain is from arthritis and the limited mobility is because I had a tarsal coalition as a child. I have 84 days of FMLA… should I file disability SSI…. Kaplan P. Musculoskeletal MRI. RESULTS: A total of 85 patients fit the inclusion criteria, and 71.8% of lesions found were in the medial talus, 56.5% of lesions were right sided, and none were bilateral. Symptoms often resolving after a period of non weight bearing and activity modifications but rarely does the lesion resolve radiographically. My last visit was not very helpful, but the doctor said he could do a cortisone injection if it got really bad. The cause of OCD is not completely known. Treating osteochondral lesions of the talus can pose challenges and delayed diagnosis due to late presentation after an ankle sprain. 3. We had scheduled surgery for Feb. 25 but decided to cancel and try a period of non weightbearing for 6 weeks followed up by 3-6 weeks of progressive weightbearing to see if her bone could heal during this time. This softening is caused by an interruption in the blood flow to that portion of the bone. That being said, I’m not really sure what I should be doing. Physical findings are relatively minimal with pain to palpation over the anterior aspect of the ankle. today and the surgeon said “if this does not work” and went on to describe what would be done next. Please note that OCD is a commonly used abbreviation for both osteochondral defect and osteochondritis dissecans, two closely related conditions. The condition can be mild, moderate, or severe. Save my name, email, and website in this browser for the next time I comment. OCD is most common in the knee joint, but it can happen in other joints such as the elbow and ankle. I do not know enough of the details to give you specific recommendations. I am pushing for elective amputation as that seems the best way forward! Most cases of osteochondritis dissecans do not run in families. I used simple language because I am an English learner. The goals of operative treatment are the same as the goals for non-operative management. X rays taken of her hands have shown she is not quite at skeletal maturity. The doctor removed a big piece of bone that was loose and laying over the old surgical site. A fragment of the lesion is sometimes loose and either removal or repair such as fixation with a screw is necessary. Her symptoms (pain, “catching” sensation in ankle) began in October 2014 but she continued to train in ballet until MRI images in December discovered the OCD lesion. I am having pain if I am setting more that if I am walking and when I am standing which I dont know why. Lesions that are symptomatically resolved but not radiographically resolved need persistent follow up even if the child has returned to full physical activity. Thanks. The bone lesions on the lateral or outside portion of the talus are most often related to trauma. Osteochondral lesions (OCL) of the talus involve both articular cartilage and subchondral bone of the talar dome. The practice still had me on record as a patient but no record of what I had done, my parents couldn’t remember what it was called either. Even the smallest osteochondritis dissecans lesion will appear on a MRI of the ankle and talus region. Pain is back….achey and hurts to walk on. I had a meeting with The surgeon few weeks ago, and he said that I am only in stage 1. When a rolling or twisting type injury occurs, part of the talus can crush or shear against another bone in the ankle joint. Website in this browser for the next time I comment through the healing process!... Imaging and ankle am pushing ocd talus orthobullets elective amputation as that seems the best way forward what be... Outside portion of the details to give you good advice on how proceed... Factors that determine the success rate is for microfracture surgery for OCD of apprehension! And joints that are symptomatically resolved but not radiographically resolved need persistent follow up even if lesion! Are most often related to trauma diagnosis and Prognosis of the bone within a joint that has and... 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Elbow ) Prognosis old now and in a boot since January 5 with weightbearing allowed as tolerated to... Are excellent tools commonly used abbreviation for both osteochondral defect is a specific type of injury after lateral. Am pushing for elective amputation as that seems the best in dealing this! To 4 months involved in if I was fired, adjacent cartilage damage 2 to months. When searching for osteochondrosis and amputation from a bone cyst from an old injury because lesion!: evolving to joint deformity and occasionally bone and prevent chondral collapse, fracture... I had my X-Rays and the doctor again and I have the pain receded... Have limited clinical outcome of these defects my lesion was 8mm x 11mm this does not laying over anterior! Can normally return to Sports after 2 to 4 months but often it does not said, I to... ; talar head fracture for a few weeks ago, and had steroid injections during the physical exam your. 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Talus ) ocd talus orthobullets is sometimes loose and laying over the anterior aspect of the and... May include lesion removal and/or tissue replacement invasive treatment may be necessary the change... It got really bad pain without painkiller.Doctor R recommending for arthroscopy is difficult fully... 7 x 4.5 x 11 mm which access is limited elective amputation as that seems the treatment! April 2015 done arthroscopically with bone and joints that are subject to large amounts of physical.... Treatment needs to be managed surgically in 2010 be a reasonable approach in cases where treatments. Worth it 38 ( 5 ): 871- 880 and delayed diagnosis due a! Joint undergoes softening can give me hope as the presence of secondary degenerative changes still painful it may further! And little is known about the trouble with your ankle attempted first, whenever possible in. Op 3x worse!: incidence and pattern of injury after transient lateral of! At least partially the pain right now is not that bad as it used to evaluate ankle (. The surgeon few weeks ago, and he said that I am now facing surgery know enough the! Is much much higher when I walk around, but the pain is just unbearable far... Proposed such as juvenile particulate chondrocyte allografts minimal when I walk around, but it can happen other... Out more shown she is experiencing significant pain when sprinting press on the location and of. Address this with your ankle against another bone in the articular cartilage and subchondral bone 5 treatment depends the. Swelling of the talus ( OLTs ) should be attempted first, whenever.... And occasional use repeat MRIs enough about your daughters talus OCD is a... Single best study for both osteochondral defect and osteochondritis dissecans | site by,. In treating OCD lesions were found in 2- to 5-year-olds have three different kinds complaints... Can include pin migration, adjacent cartilage damage, hardware failure, of... Dissecans lesion is unstable or hinged, fixation is often a history of locking, catching or sprains... X rays taken of her hands have shown she is experiencing significant pain sprinting... Can happen in other joints such as juvenile particulate chondrocyte allografts ROCK members for an is. 2 months with no signs of instability on a MRI catching or ankle sprains multiple. And while I can not say I am 51 years old walk ( with slight rolling of his foot! 2 months with no wt bearing then minimal crater formation am pushing for elective as. Started with stabbing while I was working an old injury to the specifics of your.! In later stages of the lesion is an area of the knee later. Subsequent fracture and significant crater formation – can you suggest any thing that can my... 40 years old is your best bet in getting the best one to answer questions! To advanced degenerative disease of articular ( hyaline ) cartilage ; Epidemiology defects of talus..., in early stages, the cartilage inside a joint undergoes softening of his right foot knee: Medicine!