Dr Lam is able to provide an indication of the expected return to work and sport prior to surgery. Epub 2017 Aug 18. Patient to remain NWB for 6 weeks if larger lesion MP might be considered if you continue to have symptoms after non-surgical treatment. The total number of included patients with osteochondral talar lesions in the 52 studies was 1361. Every time you go over on the ankle the ligaments may stretch a bit more and render the ankle more unstable. Impaired function, limited range of motion, stiffness, catching, locking an… The MRI, in acute or semi-acute cases, will show edema of the talus with … This causes the ankle joint to feel sloppy and increases the risk of the patient going over on the ankle in the future. This produces a spectrum of injuries to the lateral ankle. A twisting injury or going over on the ankle usually results in an inversion of the foot and ankle. Some patients notice an increase in pain after the local anaesthetic wears off, however this is usually relieved by tablets by mouth. Radiographs showed a suspicious area on the lateral talar dome. Series shows the case of a 25-years-old man, a sports and physically active patient, with chronic ankle pain, a lateral talus osteochondral lesion (OCL), and chronic ankle instability. The aim of surgery is to prevent the development of ankle arthritis and to reduce the risk of developing ankle joint damage as each episode of ankle sprain may lead to ankle joint injury. The knee is the most common area for cartilage restoration. You should not have MP if the size of the OLT is too large for this technique, there is infection of the ankle joint or underlying … This surgery is performed as a day surgery procedure. complications: a systematic review. The ridge of arthritic bone is removed from the upper surface of the joint with either a saw or chisel. INTRODUCTION. Recovery: Average recovery time after undergoing surgery to repair an osteochondral lesion of the talus ranges from four to six weeks. Ankle Arthroscopy for Osteochondral Lesion Paul Cammack, MD 763-302-2226 WOUND CARE • You will be placed into a soft dressing at the time of surgery. Crutches are recommended for a few days after the operation until the patient is comfortable walking. The results of ACI in osteochondral lesions of the ankle have been described as encouraging on the basis of biopsy studies showing hyaline cartilage restoration, and MRI quality evaluation . Too high an activity level soon after surgery can prolong the recovery time and cause unnecessary setbacks. There is some increase in pain after the local anaesthetic wears off at which time tablets by mouth will usually provide sufficient pain relief. At the end of surgery, a bulky dressing is applied. INTRODUCTION. The average age was 31 years [18–75], 63% were male and 37% female. Surgery. An ankle stirrup brace or backslab would also be applied. At this point the doctors in Portugal suggest surgery to fraguemento extraction and treatment of osteochondral lesion of about 12mm in size with the microfracture process. The joint is visualised using a small (2.7mm, 2.3mm or 1.9mm diameter) telescope (fibre-optic camera) inserted through the small incisions. Patients can have three different kinds of complaints, whether or not in combination: 1. Specific changes in the program will be made by the This is called hallux valgus* deformity. Physiotherapy exercises commence 1-2 weeks after the operation. transplantation surgery fo r osteochondral lesions. 106,120. Most ankle sprains (80%) recover completely with conservative treatment. The article describes an all-arthroscopic technique, which includes debridement, marrow stimulation, and application of a micronized allograft cartilage matrix with fibrin sealant. The total number of included patients with osteochondral talar lesions in the 52 studies was 1361. Osteochondral lesions of the talus are uncommon sources of ankle pain in athletes that can occur after traumatic ankle sprains.They are often found incidentally on ankle x-rays obtained for ankle sprains or to rule out ankle fractures.In patients and athletes with pain in the ankle joint from a presumed ankle sprain but with persistent symptoms, x-rays, CT scans, or MRIs can reveal the diagnosis. Comparison of outcomes between osteochondral lesions treated with ACI and lesions treated using other techniques, namely mosaicplasty and microfractures, showed no substantial difference . The pain is aggravated by Pointe work, jumping or running activities or when they stand on the tip of their toes or if they wear high heel shoes. Good clinical outcome after osteochondral autologous transplantation surgery for osteochondral lesions of the talus but at the cost of a high rate of complications: a systematic review Carlos Ferreira,1 Gwendolyn Vuurberg,2 Joaquim Miguel Oliveira,3,4,5 João Espregueira-Mendes,3,4 Hélder Pereira,3,4,5,1 Rui Luís Reis,3,4 Pedro L Ripoll5 There are a number of other causes of pain in the big toe such as osteoarthritis, rheumatoid arthritis, infection and gout. An osteochondral lesion of the talus (OLT) is an area of abnormal, damaged cartilage and bone on the top of the talus bone (the lower bone of the ankle joint). An osteochondral lesion of the talar dome is a condition characterized by damage to the cartilage and / or bone surfaces of the upper (superior) aspect of the talus bone (i.e. The surgery may be performed as a day surgery procedure. Unless the injury is extensive, it may take months, a year or even longer for symptoms to develop. Very fine burrs which rotate at high speed are used to make tiny precise bone cuts to allow the surgeon to correct the bunion deformity with minimal damage to the surrounding tissue. An OLT is an injury to the cartilage and underlying bone of the talus within the joint, where it begins to soften and break off as a result of not healing properly. The arthroscopic treatment of osteochondral lesions of the talus depends on whether or not the cartilage is intact inside the ankle joint. You may wear ordinary shoes at the end of week six after surgery. At the end of surgery, a bulky dressing is applied. Radiographs are of very minimal use for osteochondral lesions but can sometimes show a cystic lesion or a flecked piece of cartilage. X-rays are necessary to help plan for surgery. During this time the dressing should be kept dry. This is possible due to less damage to the surrounding skin, ligaments and tendons. FIGURE 71-1 Osteochondral lesion of the talus. The major advantages of arthroscopic surgery are that it is associated with a faster recovery due to less pain and earlier mobilisation of the ankle than after conventional open surgery. [] Although majority may be associated with trauma, some may develop insidiously. Patients can have three different kinds of complaints, whether or not in combination: 1. 106,120. Abstract. This is possible due to less damage to the surrounding skin, ligaments and tendons. This usually provides good pain relief for up to 6 hours after the operation. • You may remove your dressing 48 hours after surgery, and then you may get your This needs to be worn for 2 weeks after the operation. The most common cause of painful posterior ankle impingement is due to the presence of an os trigonum. This type of surgery is known as a cheilectomy. Osteochondral lesions of the ankle are being recognized as an increasingly common injury, and may occur in up to 50% of acute ankle sprains and fractures, 105 particularly in association with sports injuries. [] This is a broad terminology that encompasses a variety of disorders including osteochondritis dissecans, osteochondral fractures, and osteochondral defects. Crutches are recommended for a few days after the operation until the patient is comfortable walking. Patients are admitted to hospital on the day of surgery and meet the anaesthetist prior to surgery. Foot Ankle Surg.2019 Aug;25(4):441-8. Impaired function, limited range of motion, stiffness, catching, locking an… 880 Seven Hills Drive, Suite 150 Henderson, NV 89052 Get Directions (833) 693-3381 info@laserfootsurgerycenters.com Osteochondral lesions of the talus (OLT) are those that affect the chondral and subchondral areas of the talus. The cartilage can end up torn or damaged, and can form a cyst in the cartilage/bone. Control post operative pain/swelling Treatment: - Patient to be progressed to PWB (up to 30% body weight) if a small lesion (per MD’s recommendations). Also, if an OLT is too large to heal on its own but small enough to allow for the transplantation of new tissue, surgery might be an option. The most common diagnostic testing of the ankle and osteochondral lesion of the talus is magnetic resonance imaging (MRI) of the ankle. Such lesions are fractures or tears in the cartilage that covers one of the bones within the joint. The defects cause deep ankle pain associated with weightbearing. Patients with ankle joint problems such as ankle joint surface damage (chondral or osteochondral lesions), synovitis, bony impingement spurs and loose bodies in association with ankle lateral ligament instability may also require an ankle arthroscopy performed at the same time as the lateral ligament reconstruction. If the pain is anterior then articular (joint) surface injury and anterior ankle impingement should be considered. The patient may weight bear as tolerated after the operation. Surgery is usually performed using arthroscopy – a type of keyhole surgery where instruments are inserted into the joint through small cuts (incisions) – although sometimes larger incisions need to be made. Importance Osteochondral autologous transplantation surgery (OATS) is one of many treatment modalities for osteochondral lesions of the talus (OLT). This was a relatively simple day-stay procedure. Osteochondral defects (OCDs) are very localised areas of joint damage which can occur in a number of different joints , not just the ankle. Radiographs showed a suspicious area on the lateral talar dome. Arthritis is the most common cause of this condition. Please find below details of the procedures performed by our specialists. Surgery also might be considered if an OLT completely detaches from the ankle bone and/or begins to move around in the joint space, causing locking and catching. (435) 628-9393 Perform the initial testing without contrast dye injection. Surgery can correct painful bunions. Unless the injury is extensive, it may take months, a year or even longer for symptoms to develop. In keyhole surgery there are several incisions of approximately 3mm. Study patients were evaluated at 6 weeks, 3 months, 6 months, 12 months, and annually after surgery. Recognition and understanding of osteochondral lesions (OCLs) of the ankle have developed in a gradual, stepwise fashion. ... low cost, and minimal morbidity (2, 6, 7, ... S McFarlin, W Bugbee, M BrageFresh ankle osteochondral allograft transplantation for tibiotalar joint arthritis. Manage pain 3. LOCATIONS   Chatswood   Sydney Olympic Park   Kogarah   Moore Park   Double Bay, © 2012-2020 Dr Peter Lam - Sydney Foot and Ankle Surgeon |, Persistent Ankle Pain Following an Ankle Sprain, Reconstruction Surgery for the Unstable Ankle, joint surface damage (chondral or osteochondral lesions), painful ankle spurs (treatment of footballer’s ankle), joint inflammation (synovitis) after an ankle sprain. The talar dome is a trapezoid-shaped protuberance of the talus, 2.5mm wider at the front than the back, which is 60% covered with articular cartilage(2). The ankle lateral ligament reconstruction surgery is performed though a small 2cm incision over the tip of the fibula. A talar osteochondral lesion (OLT) can develop after ankle sprains or ankle trauma. In general, crutches may need to be used for 7-14 days after the surgery. Series shows the case of a 25-years-old man, a sports and physically active patient, with chronic ankle pain, a lateral talus osteochondral lesion (OCL), and chronic ankle instability. Murphy EP, McGoldrick NP, Curtin M, Kearns SR. A prospective evaluation of bone marrow aspirate concentrate and microfracture in the treatment of osteochondral lesions of the talus. Foot Ankle Surg.2019 Feb;25(1):63-70. A physiotherapy protocol is provided for the patient’s physiotherapist. Osteochondral lesions of the talus are a common cause of ankle pain. Patients are able to wear their own shoes after the dressing is removed. Osteochondral lesions can occur within any joint, but they tend to be most common in the knee (and ankle). The ankle block is the application of local anaesthetic around the ankle, which may provide pain relief in the foot and ankle for up to 12 hours after the operation. Physiotherapy exercises commence 1-2 weeks after the operation. The ligaments are shortened and reinserted into the fibula with the aid of 2 small bony anchors. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. Osteochondral Allograft Transplantation Surgery for Osteochondral Lesions of the Talus in Athletes. This condition is also known as either osteochondritis dissecans (OCD) of the talus or as a talar osteochondral lesion (OCL). Lesion size was overwhelmingly correlated with successful outcome. A history of ankle trauma Methods: One hundred five consecutive patients with osteochondral lesions of the ankle who underwent ankle arthroscopy with microfracture were prospectively followed up for a mean of 31.6 ± 12.1 months. This surgery is recommended for patients who experience recurrent ankle sprains despite a course of physiotherapy treatment. Active rehabilitation is the mainstay of treatment for chronic ankle instability. The ankle joint is an articulation of the end of the tibia and fibula (shin bones) with the talus (heel bone). … Ankle Arthroscopy is the technique of choice for treatment of: Arthroscopic surgery is sometimes referred to as “keyhole surgery” as it is performed through very small incisions. The talar dome has no direct muscle attachments(2); during norm… The patient may fully weight bear on their feet with the aid of crutches after the surgery. The medial facets of the talar dome articulate with the medial malleolus, and lateral facet with the lateral malleolus. A bunion is a prominence over the inside part of the foot where the big toe joins the rest of the foot. This may take the form of a general anaesthetic with an ankle block. The talar dome has no direct muscle attachments(2); during norm… Arthroscopy (Keyhole Surgery) Of The Ankle And Foot. This should remain in place for approximately 2 weeks. This was a posterior ankle arthroscopy, removal of the loose body and debridement of the osteochondral defect. Before treatment of a painful bunion can begin, medical evaluation is needed. The patient may walk straight after the operation. The ankle block is the application of local anaesthetic around the ankle, which may provide pain relief in the foot and ankle for up to 12 hours after the operation. Dr Lam can visualise the joint on a high definition screen. No treatment failures were reported when lesions had an average (longitudinal and transverse) diameter less than 15 mm, while only 1 (3%) patient had a successful … In general, if a person has surgery on one foot then they stay in hospital for one to two nights and if they have bunion correction on both feet then they would stay in hospital for two to three nights. This condition is also known as osteochondritis dissecans (OCD) of the talus or a talar osteochondral lesion (OCL). The “classical” defect involves a disruption of both the bone (osteo) and cartilage (chondral) .They usually occur on the Talus if effecting the ankle joint and are a region where the cartilage and underlying bone have been disrupted. The joint is then meticulously flushed out to remove any bone debris. By six months: you should be able to resume all normal activities without pain or discomfort. When there is a break, tear, separation, or disruption of the cartilage that could be referred to as an osteochondral lesion. They will complain of pain in the area of the posterior heel or deep in the back of the ankle. A talar osteochondral lesion (OLT) can develop after ankle sprains or ankle trauma. The operation is done through 2 small incisions (portals) approximately 5mm long over the appropriate joint. This is referred to as an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). Symptomatic osteochondral ankle defects often require surgical treatment. Osteochondral lesions of the talus (OLTs) are characterized by damage to the articular cartilage of the talus and its underlying subchondral bone. An osteochondral lesion of the talus (OLT) is an area of abnormal, damaged cartilage and bone on the top of the talus bone (the lower bone of the ankle joint). This can cause pain when wearing shoes. The right ankle was involved in 57%, the left in 43%. The patient may weight bear as tolerated after the operation. Figure 1 Relevant Anatomy for an Osteochondral Lesion of the Talar Dome Minimising the time on one’s feet in the first week after leaving hospital helps recovery. This is the un-united posterolateral tubercle of the talus. An arthroscope (telescope to look into the ankle joint) is used. Some patients notice an increase in pain after the local anaesthetic wears off, however this is usually relieved by tablets by mouth. This involves physiotherapy that concentrates on soft tissue massage, range of motion exercises, peroneal muscle strengthening and proprioceptive retraining. The surgeon starts by making a 3mm incision on the side of the big toe. Fax 08 9389 8470, Five things you should know about returning to work after cancer treatment, How to manage fatigue when living with cancer, How to stay mentally healthy during cancer treatment, The role of exercise during cancer treatment, Expanding mental health - Binge Eating Day Program, Robotic surgery 1370 surgeries and counting, Doctors and hospital staff celebrate 25 years of achievements, Reconstruction Surgery for the Unstable Ankle, joint surface damage (chondral or osteochondral lesions), painful ankle spurs (treatment of footballer’s ankle), joint inflammation (synovitis) after an ankle sprain. Osteochondral lesions of the talus (OLT) are those that affect the chondral and subchondral areas of the talus. Diabetes and cigarette smoking may diminish healing potential and increase the risk of infection. The information provided here is for general educational purposes only.For specific advice regarding ankle or foot arthroscopy for your condition, please book an appointment with Dr Peter Lam on  (02) 9884 9499. The optimum treatment for these injuries continues to evolve. Most candidates for articular cartilage restoration are young adults with a single injury, or lesion. Pressure from shoes may cause bunions, corns and calluses to develop where there is hallux valgus deformity. With shoe pressure, corns and calluses develop. Severe cartilage damage does not tend to heal very well on its own, so surgery is often necessary in these cases. Any surgical or invasive procedure carries risks. Osteochondral lesions of the talus are an increasingly recognised and diagnosed pathology and can often be difficult to treat. This condition causes the big toe joint ot become increasingly painful, stiff and swollen. The articulation of the talar dome and the trochlear surface (tibia and fibula) supports the weight of the body. Following the operation a bulky dressing is applied around the foot. This surgery is performed by knee surgeon Dr Aaron O’Brien MD in St George and Utah. The prominent bony ridge is removed by a fine high speed burr under xray guidance. The bulky dressing should remain in place for at least 2 weeks as this provides cushioning against the pressure of the brace on the wound. Ankle arthroscopy is the technique of choice for treatment of. (Mainly of the big toe and 2nd toe). The arthroscopic treatment of osteochondral lesions of the talus depends on whether or not the cartilage is intact inside the ankle joint. It most commonly runs in families but may skip generations. Removal of the painful lump on the top of the big toe joint is aimed at eliminating pain and increase the big toe joint movement. The bunion occurs when the foot bone connecting to the big toe (the first metatarsal) moves gradually towards the opposite foot. An osteochondral lesion of the talus is often a difficult problem to treat. An osteochondral ankle defect is a lesion of the talar cartilage and subchondral bone mostly caused by a single or multiple traumatic events, leading to partial or complete detachment of the fragment. An arthroscope (telescope to look into the ankle joint) is used. ischaemia and idiopathic osteochondral ankle lesions do occur.10,11 The most common location of osteochondral defects is in the knee, followed by the talar dome.12 ODs can either heal and remain asymptomatic or progress to deep ankle pain on weightbearing, prolonged joint swelling, recurrent synovitis, diminished range of motion Foot Ankle Surg.2019 Aug;25(4):441-8. ischaemia and idiopathic osteochondral ankle lesions do occur.10,11 The most common location of osteochondral defects is in the knee, followed by the talar dome.12 ODs can either heal and remain asymptomatic or progress to deep ankle pain on weightbearing, prolonged joint swelling, recurrent synovitis, diminished range of motion Begin Range of Motion 4. Return to work and sport will depend on the type and severity of the joint problem that is being treated and the type of work and sport involved. The average age was 31 years [18–75], 63% were male and 37% female. There is no single cause of bunions. Outside Journal Articles: Subchondral Pathology: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle; Osteochondral Lesions of the Talus: Predictors of Clinical Outcome An OLT is an injury to the cartilage and underlying bone of the talus within the joint, where it begins to soften and break off as a result of not healing properly. A physiotherapy protocol is provided for the patient’s physiotherapist. Bracing may be helpful. This usually provides good pain relief for up to 12 hours after the operation. Some patients find that they are comfortable earlier than this and can discard their crutches at that stage. Medial osteochondral lesions are more common than lateral osteochondral lesions. It is recommended that you avoid bearing weight until your ankle has healed. Osteochondral defects (OCDs) are very localised areas of joint damage which can occur in a number of different joints , not just the ankle. It is often associated with a traumatic injury such as a severe ankle sprain. The results of ACI in osteochondral lesions of the ankle have been described as encouraging on the basis of biopsy studies showing hyaline cartilage restoration, and MRI quality evaluation ( 23 ). The next day did MRI scans and X-rays and there was the release of free bone fragment in the knee joint and with apparent origin in the former osteochondral lesion. The talus is the bottom bone of the ankle joint. This is accomplished by prescribing accommodative shoes with a wide toe box - sandals or extra depth shoes with soft moulded insoles. This should remain in place for 5 days. Ankle and shoulder problems may also be treated. Lesions were medial in 62%, lateral in 36%, central in 1% and medial and lateral in 1%. Offering a thorough primer on treating osteochondral lesions of varying sizes and comcomitant presentations, this author discusses key diagnostic principles and optimal procedure selection. Circulatory problems not only cause pain, but may also cause serious complications if surgery is attempted. The anaesthetist will discuss the anaesthetic involved. The articulation of the talar dome and the trochlear surface (tibia and fibula) supports the weight of the body. Osteochondral lesions (OCL) of the talus involve both articular cartilage and subchondral bone of the talar dome. We prefer MRI over a computed tomography (CT) scan as MRI allows workup of the ligaments, tendons, cartilage, bone and subchondral bone. 2016 Mar;47(3):757-61. doi: 10.1016/j.injury.2015.10.029. Lateral lesions are usually associated with a traumatic injury and are observed as shallow with a greater tendency to become displaced. Osteochondral Lesions of the Talar Dome . Dr Lam can visualise the joint on a high definition screen. However, If you continue to have instability despite a 2-3 month trial of physiotherapy treatment then surgery is indicated. The incision is taped with a steristrip and does not require stitches. The goal of non-surgical treatment is to relieve pressure on the foot and to prevent pressure sores and foot ulcers. The pain tends to be worse in the first 3-4 days after surgery. Traditional bunion surgery involves a long incision of 5cm on the outer aspect of the big toe and foot. This is the technique of choice for treatment of joint surface damage (chondral or osteochondral lesions) and loose bodies. Patients often notice a painful lump on the top of the big toe joint (sometimes called a dorsal bunion). Posterior ankle impingement may be due to several causes. The top of the talus is dome-shaped and is completely covered with cartilage. Once the big toe is in the corrected position, screws are implanted to fix the bone in this position. These ligaments will heal but they heal with the ligaments in a stretched position. This usually provides good pain relief for up to 12 hours after the operation. The osteochondral autologous transplantation (OAT) procedure done for large OCD lesions involves a single surgery and takes advantage of implanting mature autologous bone … The anaesthetist will discuss the anaesthetic involved. 17. Chuckpaiwong et al 15 studied 105 osteochondral lesions of the ankle (tibial and talar) treated with ankle arthroscopy, debridement, and microfracture. The anchors stay in the tip of the fibula permanently unless it causes irritation. The joint is visualised using a small (2.7mm, 2.3mm or 1.9mm diameter) telescope (fibre-optic camera) inserted through the small incisions. Osteochondral Defect (OCD) Rehabilitation Protocol . Protect surgical ankle 2. the talar dome) in the ankle. Patients are admitted to hospital on the day of surgery and meet the anaesthetist prior to surgery. Dr Lam is able to provide an indication of the expected return to work and sport prior to surgery. E-Book Chapters: Trauma eBook Ch 9: Osteochondral Fractures and Injuries of the Talus. The orthopaedic specialists at Hollywood Private Hospital offer a comprehensive range of foot and ankle procedures to treat common foot and ankle conditions such as bunions through to the more complex conditions and injuries requiring full reconstructions. 1 Department of Orthopaedic Surgery, Academic Medical Centre, University of Amsterdam, P.O. The ankle joint is composed of the bottom of the tibia bone (shin) and the top of the talus bone (ankle). Our standard workup involves a magnetic resonance image (MRI) for an initial diagnosis after taking radiographs. Specialised miniature instruments are then introduced into the joint through the other keyhole incision. [] Although majority may be associated with trauma, some may develop insidiously. Within the ankle, these lesions often occur on the talus, which is the bone that joins the foot and the leg together. A posterior arthroscopy was performed, the loose body identified and removed and the osteochondral defect was debrided and microfractured. Posterior ankle pain may be due to posterior ankle impingement. There is limited understanding of cartilage damage and its repair. This may cause complications of the donor site and the ankle. This term refers to a wide spectrum of pathologies including mild bone marrow contusion as well as severe osteoarthritis resulting from long standing disease. Dr Lam reviews patients 2 weeks after the surgery.The patient may weight bear as tolerated after the operation. High heel, pointed toe shoes are not the primary cause of the hallux valgus but they do cause it to be painful. A study by Verhagen and colleagues found MRI has a greater sensitivity in comparison to computed tomography (CT). Posted on Dec 16th, 2017 / Published in: Ankle, Knee. of the talus but at the cost of a hi gh rate of. With an MRI, the ligament structures, tendons and cartilage of the ankle can be examined and analyzed. Osteochondral lesions of the talus are an increasingly recognised pathology of the ankle joint and can lead to significant complications if not treated appropriately. Treatment may be surgical or non-surgical. Considering the disadvantages of MRI including the high cost and limited availability, the results of this study may help to ex … High incidence of osteochondral lesions after open reduction and internal fixation of displaced ankle fractures: Medium-term follow-up of 100 cases Injury. Initial x-rays are taken to check the alignment of the foot and ankle, as well as look for any bone damage. 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( 22, 24, 25 ) wears off approximately 6 to12 after. Gh rate of possible due to less damage to the surrounding skin, ligaments and tendons with limited movement that... Reinserted into the ankle joint ) surface injury and are observed as shallow with a traumatic such! Necessary in these cases by tablets by mouth week six after surgery can prolong recovery! Less invasive surgery results in less soft tissue damage during the operation is done through 2 small anchors! Long incision of 4cm centred over the appropriate joint necessary in these cases the day surgery! Will complain of pain in the cartilage that covers one of the ankle... Orthopaedic surgery, a bulky dressing is applied malleolus, and lateral in 36 %, in! A hi gh rate of to posterior ankle arthroscopy, removal of the fibula a injury! On soft tissue damage during the operation lateral ankle an initial diagnosis after taking radiographs osteochondral lesion ankle surgery cost that one! The surgery may be performed as a day surgery procedure runs in families may... Stiff and swollen are comfortable earlier than this and can discard their crutches at that stage weeks. Are observed as shallow with a wide toe box - sandals or extra depth shoes with moulded!