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Osteo Chondritis Dessicans

Osteochondritis Dessicans or OCD is a medical condition of the ankle that exists in the talus bone where the cartilage and the bone lying under it are damaged. OCD is also called Osteo Chondral Lesions. The injuries include the cartilage layer blistering, cyst like lesions within the bone or fracture of the cartilage and bone layers. It happens without obvious cause (idiopathic) or it can happen after injury aswell. Symptoms are pain in the ankle , difficulty in walking, running ,playing sports . mechanical symptoms like locking, loose body sensation and instability.



Non-Surgical Methods
The different non-surgical treatment options are:

  • Rest: Giving proper rest to the ANKLE is the first step towards recovery. The patient is recommended to stay away from sports or strenuous activity.
  • Plaster: or a walking boot is recommended by doctors to relieve the symptoms by providing support to the ankle.
  • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): like Ibuprofen etc., can help reduce the pain and swelling.
  • Physical Therapy: is usually recommended with exercises for muscle strengthening and to reduce stiffness and increase flexibility.

Surgical Methods
Indications for surgery are pain, limited activities, mechanical symptoms like locking in the ankle and restriction of movemnets.
The surgery is performed in order to restore the Talus bone’s normal shape and gliding surface so that the normal mechanics and the joint forces are reestablished. Thus minimizing the symptoms and limiting arthritis. The surgical treatments will include Debridement or removing the damaged bone and cartilage, fixing the injured fragment, micro-fracture or drilling of the lesion and bone & cartilage grafting. The best option is Ankle Arthroscopy technique to perform the different treatments.

Ankle Arthroscopy
This is a minimal invasive surgical procedure performed to diagnose and treat problems in the ankle joint.
Basically, the doctor will make a very small incision and insert the Arthroscope, a tiny camera, into your ankle enabling them to view the inside of the joint on the screen. The surgeons will then investigate the issue with the ankle and decide on the type of procedure needed , depending on the size of the lesion and symptoms.
The loose fragments of bone and cartilage will be removed and The defect’s base is then drilled with fine wires or micro-fractured, creating small holes and channels to allow tiny blood vessels to grown and improve the blood supply to the talus. Or a bone marrow aspirate rich in stem cell is injected along with a glue to stimulate healing of new cartilage and rarely a cartilage biopsy is done and sent to laboratory to grow and re implanted later is called autologous chondrocyte implantation can be done.

Ankle Stem Cell Treatment
This is an alternative to most of the traditional approaches to Ankle joint pain treatment. If these cells are placed in a certain environment, they transform themselves to suit that environment. For instance, stem cells placed near a damaged cartilage will develop into a cartilage tissue later on.
The common type of stem cells used for treating arthritis is called Mesenchymal Stem Cells. They are usually collected from a patient’s fat, blood or bone marrow. This process of collecting stem cells is called Harvesting.
This treatment basically extracts stem cells from an area of high density and then injects them into the damaged is to help heal the body naturally.

Authored by Dr Banarji B.H - Shoulder Surgeon, Bangalore

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