In plain language
Focal injury of talar articular cartilage and underlying bone, sometimes with a fragment, subchondral cyst or marrow edema.
Clinical Significance & Management
Symptoms, depth, stability, ankle instability and alignment guide care. Stable mildly symptomatic lesions may start with load reduction, bracing and rehabilitation. Displaced fragments, locking or persistent symptoms warrant surgical assessment.
Symptoms & Clinical Presentation
Deep weight-bearing ankle pain and recurrent swelling
Catching, locking or lasting post-exercise discomfort
Etiology & Injury Mechanisms
- Ankle sprain or fracture
- Repeated microtrauma; sometimes no clear cause
Diagnostics & Imaging Guide
Examine stability, alignment and motion; X-rays can miss lesions
MRI assesses cartilage/marrow; CT characterizes bone and cysts
Treatment Options
Protected loading with strength and balance work
Select fixation, marrow stimulation or grafting by fragment, depth and prior treatment
Rehabilitation Milestones & Timeline
Rehabilitation depends on the diagnosis, procedure and associated injuries. Progression requires assessment of healing, symptoms and function; elapsed time or a single test cannot determine readiness for sport.
Unload
Protect the surface according to symptoms or surgery
Recover
Progress motion and strength; loading is procedure-specific
Sport
Assess swelling, strength and impact tolerance before running/jumping
Evidence-Based Clarifications
Area alone cannot select microfracture, fixation or transplantation. Techniques have different indications and evidence; pain or degeneration may persist.
Sources & References
Talar Dome Lesion
American College of Foot and Ankle Surgeons (ACFAS)
Osteochondral Lesions of the Talus: Diagnosis and Conservative Management, 2023 Recommendations
DGOU / Cartilage
Operative management of osteochondral lesions of the talus: 2024 recommendations
DGOU / EFORT Open Reviews
Educational clinical definitions synthesized from AAOS, Cleveland Clinic, Mayo Clinic, and HSS. Individual diagnosis and surgery require professional medical evaluation.
Publication date
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