The Center for Podiatric Care and Sports Medicine

Ankle Angst: Osteochondral Lesions of the Talus

Posted by on Thursday, October 11th, 2012


I’m sure you’ve heard many a person explain a limp with, “I sprained my ankle.” But how many times have you had someone say, “I have an osteochondral lesion of the talus?” Probably none–but if you have, you may be spending way too much time with podiatrists and orthopedists (I know! You’re thinking, “You can never spend too much time with podiatrists!”).

Nevertheless, it is indeed an ankle injury that can affect anyone–even you–so let’s talk about osteochondral lesions of the talus.

Can we shorten that? Give it a nickname or something? How about an acronym? The injury is commonly referred to as an “OLT.” It’s also called osteochondritis dissecans of the talus, or OCD of the talus. Let’s stick with OLT for now.

Okay, that’s better. Now what is it? An osteochondral lesion is a fracture or injury to the cartilage; the talus is the big chunky bone that sits on top of the calcaneous, or heel bone. It’s part of the tarsus, or the complex of bones that make up your ankle. Therefore, an OLT is a fracture to the cartilage that sits on top of the talus (now that you’ve got that down, tackle the meaning of peptides and how they help your skin).

Now how on earth would I, or anyone else, injure that? It takes a pretty extreme event. They almost always occur along with a severe ankle sprain, especially one that happens when you land hard on your ankle, jamming the tibia (shin bone) hard onto the talus.

So if I have a sprained ankle, how do I know I have an OLT as well? It’s actually really tricky–there’s nothing that jumps out immediately to say, “Hey, we’ve got an OLT with this sprain!” In many cases, you won’t discover the additional injury until after the sprained ankle seems to be healed and you try to go back to normal activity, but develop a new batch of pain and swelling around the ankle. At that point, you should see a podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900) for an accurate diagnosis; an MRI or CT scan is usually necessary to find an OLT.

Let’s pretend that I have been through the MRI or CT scan process and indeed do have an OLT? What do we do about it (we meaning me and my podiatrist)? It depends on the severity of the injury. If it’s a small fracture with all the cartilage still in place, it can be treated non-surgically. You’ll have to keep weight off your ankle, and may be given a brace, but you should do some activity to keep it mobile; a podiatrist will probably recommend physical therapy.

If, however, pieces of cartilage have been knocked out of place and there are fragments floating around, you’ll need arthroscopic surgery to clean that up. Luckily, arthroscopic surgery is minimally invasive and it won’t be long before you’re ready for a rehab program.

The most frustrating part of an osteochondral lesion of the talus (let’s get that full name in once more for old time’s sake) is just figuring out that you have one. Once you know what’s causing your ankle pain, treatment is fairly straightforward and you’ll soon be on your way to NOT doing whatever injured your lovely talus in the first place!


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.