Cartilage Injuries and Osteochondral Injuries of the Ankle

What are Cartilage Injuries and Osteochondral Injuries of the Ankle?

Cartilage injuries and osteochondral injuries of the ankle refer to damage to the cartilage that lines the joint surfaces and, in some cases, to the underlying bone. These injuries can compromise joint function and cause significant pain. Osteochondral injuries involve not only the cartilage but also the underlying bone, forming a more complex injury.

Causes of Cartilage and Osteochondral Injuries

Common causes include:

Trauma: Direct impacts to the ankle, such as those occurring in accidents or during intense sports activities, can cause injuries to the cartilage and underlying bone.
Sprains: Severe ankle twists that result in damage to cartilage and bone.
Overuse in deformities: Repetitive activities that place constant pressure on the ankle joint can lead to cartilage wear and development of osteochondral injuries.
Fractures: Ankle fractures that affect the articular area can result in osteochondral injuries if not properly treated.

Symptoms of Cartilage and Osteochondral Injuries

Typical symptoms include:

Persistent pain: Localized pain in the ankle that may worsen with activity and improve with rest.
Swelling: Fluid accumulation in the joint due to inflammation.
Stiffness: Difficulty moving the ankle completely, especially after periods of inactivity.
Crepitation: Sensation of clicking or friction when moving the ankle.

Diagnosis of Cartilage and Osteochondral Injuries

To diagnose these injuries, doctors use:

Physical examination: Assessment of pain, swelling, range of motion, and ankle stability.
Imaging Tests: X-rays can show fractures or bone changes, as well as computed tomography (CT), while magnetic resonance imaging (MRI) is essential to visualize the extent of injuries to cartilage and underlying bone.

Treatment of Cartilage and Osteochondral Injuries

Treatment varies according to injury severity:

Conservative: Includes rest, ice application, ankle elevation, and use of anti-inflammatories to control pain and inflammation. Physical therapy may be recommended to strengthen muscles around the ankle and improve mobility.
Surgical: In more severe cases or when conservative treatment is not effective, procedures such as ankle arthroscopy to clean the injured area or cartilage repair may be necessary. Advanced procedures may include cartilage transplantation or microfracture to stimulate new cartilage growth.

Prevention of Cartilage and Osteochondral Injuries

Some preventive measures include:

Muscle strengthening: Exercises to strengthen muscles around the ankle and improve joint stability.
Movement techniques: Training to improve technique during physical activities, reducing risk of twists and impacts.
Appropriate equipment: Use of appropriate footwear to provide adequate ankle support and, when necessary, orthoses to protect the joint during high-risk activities.

Conclusion

Cartilage injuries and osteochondral injuries of the ankle can cause significant pain and limit joint functionality. Identifying symptoms early and seeking medical evaluation are essential steps for effective treatment. With appropriate treatment and preventive measures, many individuals can recover ankle function and resume their activities safely.