Hi All-
I found this post a while ago and after my surgery I thought I'd share my experience. About four years ago I sustained a lesion on the inside of my talus. It was rather small as told to me by my doctor; not large enough to pin but I don't remember the exact size. I underwent surgery a little over two months ago. They removed the defect and I think a little more to make sure they got the whole thing. They also drilled to stimulate bone and cartilage growth; I noticed five small holes on my ankle where I think they went in with what I believe is called the kirshner wire (sp?). Again, I am two months out and have noticed the instability I had before is gone but there is still pain especially when I make certain movements. I'm definitely optimistic and had a two month dr.'s appointment yesterday. He was happy to see no swelling and minimal pain in the joint though in looking at the xray there was minimal noticeable bone regrowth which brings up my first question. Does anyone have any experience on how long it takes for bone to regrow and has anybody come across any medications, herbal remedies, or other procedures that aid in the advancement of bone growth? I recently came across web pages describing Bone Growth Stimulators. Does anybody have any experience with these? I'm also curious if anyone is out there with successful or similar procedures done? I'd love to hear some successes or advice for post surgery healing. If my surgery is not successful, given time, I'd probably not go for the OATS procedure but I have noticed people talking about a second drilling? Any successes? I'm interested in hearing similar experiences.

Thanks

I will tell you my story. I had a traumatic injury involving a softball in 2001. Initially, my injury did not seem so severe, so I did not seek immediate medical help. About 3 months after my injury, I could not bear weight going up and down stairs, and my ankle would give out on me without notice. I went to my primary care doctor who sent me to an ortho. He said I had a minor lesion, and they would drill. I went in for an ankle arthroscopy, and by 6 weeks post op was virtually pain free, and remained that way for a year. My pain slowly returned, and by 3 years post op, I returned to my ortho because my ankle was once again unstable, and I was falling again, and could no longer bear the pain. He ordered an MRI, which showed advancement of the osteochondral lesion of the talar dome. He elected not to perform surgery - because he said that they wanted to do as little as possible, that the more they went in the worse for me. I suffered with the pain and falls for another 2 years, and lost the ability to perform even everyday tasks. I then decided that I could not bear it any longer, and chose to get a new ortho. Another MRI was performed, and my lesion had significantly advanced with loose fragments now present. I had an open osteotomy with OBI grafting done in July of 2006. My pain is less now, but still what I would consider moderate to severe, depending on if I am having a good day. I walk with a constant limp. Would I have done it again? Yes, the surgery improved my quality of life. The problem is that osteochondral defects do occur bilaterally in about 60% of people, and I unfortunately am one of those. My right ankle is grade 4 (before surgery), my left is grade 2, which is still considered stable, and I have elected to not have surgery on my left ankle at this time. I only wonder what the future holds for me, because I am only 30 years old. What will life be like for me in 30 years? Will I be able to walk at all? I don't know. Does anyone else have an osteochondral defect? What were your treatments? How are you now?

Thanks for your reply. I feel your pain; I turn thirty next week and have been thinking the same thing...I've only (hopefully) experienced a third of my life and I don't know what it'll be like to spend two-thirds of it like this. Out of curiosity, what is a bilateral lesion? Is the osteotomy where they take bone and cartilage from your knee? I'd considered this but my dr. suggested I do the debridement and drilling first. If that's the case, I'm curious how your knee is doing. On this same post there have been reports of people having pain in their knee afterwards.

Hi Dubby and Jenny
Back in July of O6 I was diagnoised with stage 4 lession of the talus floor, OCD, DJD and Spurs, seemed like all of it just decided to wreck havoc on my life at once! I was in an incredible amount of pain, barely able to walk. I elected to have Mosaicplasty Surgery - otherwise known as OAT's but in my case they used cadaver bone and cartilage. It no doubt is a rough surgery and recovery but it was my best option to walk again.
Overall I am pleased with the outcome, I did however expect to be 100% by now but I am not, my ankle still reminds me it is in control and limits me each day but I dont' have the pain that I had prior to surgery and most important I have an ankle that moves, I feared fusion.
I devleoped a severe case of PF when I took my first clumsy steps 11 weeks after surgery and I had never heard of PF, never had it before and I think that is halting my progress more than anything.
I wish you both the best and hopefully your ankles will behave and you'll be back to the things you love in no time.
Take care and I send all my best
Carol

Dubby - a bilateral lesion is one that occurs in both ankles. I went into surgery thinking they were going to take bone and cartilage out of my knee, and implant into my talar dome. However, when I woke up, my ortho said that my lesion was too large, that if he had done that, that I would have had an unstable knee. He did not like the outcomes with the cadaver bone and cartilage, so did not want to do that. That is an OATS procedure. I had an OBI procedure, which is where they made an open incision on the inside of my ankle, sawed the bottom of my tibia off (the bump of bone on the inside of your ankle) and then implanted a synthetic orthopeadic cement into my ankle. He also shaved off part of my tendon there because he said from "repeated strain" it was too thick. Then, he pinned the bone from my tibia back into place, and stitched me back up. I do not have the instability, I am not falling, but my pain is pretty much the same. I go back to the ortho on 4-10 (wish me luck) to have my first followup CAT Scan after surgery to see the progress. He is also going to scan my left ankle to make sure it has not progressed. I hope it hasn't because it was a tough surgery to deal with. The arthroscopy (sounds like what you had) was not as bad. But with my last surgery I was on crutches non weightbearing for 3 months, then partial weightbearing for 2 months. Then had to wear an ugly boot for another 6 weeks after that. Very hard to do household chores and be an active parent on crutches. It is amazing what you can learn about your condition thru the internet. There are all kinds of articles written by physicians about the osteochondral lesions. I try to be optimistic, but I don't like some of the statistics that I am hearing about success rates. In my case, I had to do the OBI procedure or have a fusion. I do not want to do the fusion, because I am in school to be a paramedic, and would not be able to perform with a fusion (though I have my doubts about being able to perform in my current condition also.) It is good to hear from others who have this, I feel all alone. Most people I talk to have never heard of this before. Have you done any research online about what causes these injuries? I am not having much luck, and thought my origional injury was from a softball, but if that was the case, what caused my lesion in my left ankle? I don't know. It would be nice to hear back, Jenny