Your ankle joint is formed at the bottom of your tibia and the top of your talus. The top of your talus is dome-shaped and totally covered in cartilage to help facilitate smooth movement. When this cartilage or the underlying talus bone is damaged, this is known as a talar dome lesion. In today’s blog, we take a closer look at why talar dome lesions develop and how Dr. Silverman can help you treat them.
Causes And Symptoms Of Talar Dome Lesions
A talar dome lesion, also sometimes referred to as an osteochondral defect or an osteochondral lesion, typically occur as a result of direct injury or trauma to the ankle complex. Arguably the most common mechanism of injury is during a moderate or severe ankle sprain, although any direct or significant trauma, like a fall or a car accident, can damage this protective cartilage. It is important that you recognize the symptoms of a talar dome lesion because left untreated, damaged cartilage and bone can break off and float elsewhere in the ankle.
Symptoms of a talar dome lesion include:
- Pain deep within the ankle
- Pain that is worse when bearing weight
- A clicking, catching or grinding sensation in your ankle when walking
- A “locking up” of the ankle at certain points
- Swelling
Diagnosing And Treating Talar Dome Lesions
The ankle joint is complex, and because symptoms mimic other issues within the ankle, it’s not always easy to diagnose a talar dome lesion. Your best bet is to connect with a foot and ankle specialist like Dr. Silverman. He’ll talk with you about your symptoms and conduct a physical exam of the ankle. He may manipulate your ankle to see how the joint responds to these movements, or he may ask you to perform some walking exercises. Diagnostic injections or imaging tests in the form of an X-ray or MRI can help to confirm this diagnosis.
If imaging suggests that you have a stable talar dome lesion, which means that no pieces are broken off and floating around your ankle, the doctors will likely recommend a course of conservative care. The most common course of non-operative treatment involves a combination of rest and or ankle bracing to help protect the area from additional trauma, non-steroidal anti-inflammatory medications to help combat swelling and discomfort, and targeted physical therapy to strengthen the ankle complex and expand your comfortable range of motion. Oftentimes this leads to major or complete relief within a few weeks.
If non-surgical treatment fails, or your have an unstable lesion, surgery may be the next move. Surgery will involve removing any loose bone or cartilage fragments to ensure that healing can course its course. There are a number of ways that the surgeon can debride the ankle, but it is typically done using minimally invasive techniques to limit trauma on the ankle and speed up recovery time. Most patients will then follow the above conservative care plan during their post-op rehabilitation, with a heavy dose of rest, medication and physical therapy. Recovery tends to take a little longer, but it typically yields fantastic results.