Osteochondral lesion of the talar dome
Understanding this condition
The talar dome is the upper surface of the talus (the ankle bone). An osteochondral lesion is a combined injury to the cartilage and the bone immediately beneath it, on this dome.
The cause is most often traumatic (following one or several sprains), but may also be related to a bone vascularisation disorder. This condition frequently affects young and athletic patients.
Symptoms
Deep mechanical ankle pain, present on weight-bearing, during sport, and relieved by rest. Occasional clicking or locking sensation.
Intermittent swelling is common. Pain can be moderate and overlooked for a long time before diagnosis.
How can it progress?
Without treatment, the lesion worsens: the cartilage fragment can detach (loose body within the joint) and the underlying bone can collapse. In the long term, progression is towards early ankle osteoarthritis.
Early management allows preservation of joint cartilage.
Treatment options
For small stable lesions: partial weight-bearing relief, physiotherapy, imaging monitoring. This may be sufficient for stabilisation.
For larger or symptomatic lesions, several arthroscopic surgical techniques can stimulate healing: microfractures, bone grafting, autologous cartilage grafting (AutoCart). A specialist consultation and MRI clarify the indication.