Osteochondral defects(OCD) are very localised areas
of joint damage. These conditions usually occur on
the talus and are a region where the cartilage and
underlying bone have been disrupted. How disrupted
can vary from 'bruising' to a crater or deep defect
on the surface of the joint, lacking the underlying
bone as well as cartilage. These most often, though
not exclusively, occur after some injury to the joint.
What sort of injury may result in this condition?
A not uncommon history is that of a sprained ankle which has failed to settle and gives symptoms (pain/instability) long after it should (see 'The sprained ankle' section for a more comprehensive review of this problem).
How is this condition different from arthritis?
The changes in the joint surface are very localised (often widespread in arthritis), are almost always just on the talar side of the joint (usually on both sides of the joint in arthritis) and result in softening of the joint surface (usually significant hardening in arthritis).
What symptoms might I expect?
Generally pain is the main symptom, on weight bearing and not infrequently when resting as well. It is not uncommon to also have feelings of instability from the joint.
Do I need to have it treated ?
It is unclear if an OCD will necessarily progress to osteoarthritis or what its natural history is.
A decision to have treatment can be made on the basis of whether the patient has persisting and troublesome symptoms or not.