Conservative treatment of talar cartilage injuries

Sometimes you may sprain your ankle if you are not careful when walking. This is a very easy phenomenon. If it is serious, it will cause talar cartilage damage. This disease occurs more often in men than in women. As the saying goes, it takes 100 days to heal a broken bone. Therefore, the conservative treatment time for talar cartilage damage is about one to three months. During this period, you must pay attention to rest more, do not exert force, and be sure to massage your legs frequently so that it can recover as soon as possible.

Talus osteochondral injury, also known as talar osteochondritis dissecans, has many names for this type of disease, such as transcartilaginous talar fracture, occult osteochondral fracture, etc. It is currently mostly called talar osteochondral injury. The cause of talar osteochondral injury is not completely clear, but it is considered to be similar to the mechanism of osteochondritis dissecans of the knee, that is, it is related to trauma and ischemia. This disease is mainly common in adults, more common in men than in women. Most patients have a history of ankle sprain and ankle pain after injury.

, the swelling persists and is often accompanied by stiffness, weakness, instability and even locking.

During examination, there is pain and swelling when the ankle is flexed and extended, and tenderness is often found at the inner and outer edges of the superior articular surface of the talus when the ankle is plantar flexed. Magnetic resonance imaging (MRI) significantly improves the accuracy of diagnosis and can accurately display articular cartilage, subchondral bone, fibrous cartilage, synovial fluid and granulation tissue. MRI can accurately determine the scope and extent of damage, providing an important basis for treatment.

The treatment of talar osteochondral injuries is divided into non-surgical treatment and surgical treatment. It is generally believed that for adolescent patients, if the injury area is small and the exfoliated bone fragment is stable, conservative treatment can be used, including limiting activity, wearing a brace, and medication and physical therapy.

If conservative treatment is ineffective for more than 3 to 6 months or the damaged area is large, surgical treatment should be adopted. Current surgical treatment methods include: (1) Arthroscopic surgery: including arthroscopic lesion cleaning alone and arthroscopic lesion cleaning plus microfracture (or drilling). The advantages are small surgical trauma and quick postoperative recovery. It is effective in treating small-area talar cartilage injuries, with an excellent and good rate of 83% to 93%. (2) Autologous osteochondral transplantation or chondrocyte transplantation: For cases where arthroscopic lesion cleaning and microfracture surgery are ineffective, or for cases with large-area talar osteochondral damage or deep bone cysts, autologous osteochondral transplantation, autologous bone with periosteum or chondrocyte transplantation can be tried, with an excellent and good rate of up to 90%.