By Dr. J. Halbrecht, MD, Othopaedic Surgeon, San Francisco, USA

OCD of the Talus - Osteochondritis Dissecans (OCD)

What is it? Osteochondritis Desscans (OCD) is a loss of blood supply to a segment of bone and cartilage in the talus bone of the ankle. Symptoms are usually pain in the inside corner of the joint. Often OCD cannot be detected with plain x-rays, and an MRI is necessary for diagnosis. The exact cause of OCD is not known, although a history of trauma is common.

Treatment: Occasionally in very young patients, the OCD will heal with immobilization and rest. Most often the OCD will require surgical treatment. Initial treatment involves arthroscopy to remove severely damaged fragments or drilling through the area with no blood supply into adjacent healthy bone. This allows blood supply to enter the injured area and encourage healing. In severe cases, when drilling is not effective, a new procedure allows the transplantation of new cartilage and bone into the defect. A plug of cartilage and bone is taken from a safe area in the knee joint and implanted into the defective area in the ankle. Early results using this technique are very encouraging, with most patients achieving excellent relief of pain.