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Old 06-10-2012, 02:34 AM   #1
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KDogg21581 HB User
OCD of the Talus

Hi everyone,

I'm new to health boards and right now I'm definitely stressed out. Six and a half years ago I was walking from the Biology building at college to my truck across the street. The street I had to cross was a 10 mph road. When I tried to cross a kid in a Mustang is doing about 40 mph and would have hit me had I not jumped back. When I jumped back I hit the curb with my right foot and heard a popping sound. My ankle tripled it's size instantly. I stayed that way for a week and went to the hospital. They took an x-ray and told me I was fine. It was a sprained ankle and I received crutches and a brace. My ankle has never been the same.

I ran 6 miles a day and lifted weights. I was 175 lbs and in perfect shape. Now 6 years later I'm out of shape and weigh 230 lbs. I can't run or work out too much due to the pain. I finally got a job with good insurance five years ago. Last month I get an X-ray done on the ankle that shows bone shards. Then I get an MRI and it shows I have OCD of the Talus. I have a 5mm X 5mm X 5mm lesion, I don't know the exact location of the lesion yet but I'm going to my first OS appointment a week from Monday.

I have never heard of OCD until this week and to tell y'all the truth I'm scared out of my mind. I researched the various types of operations and found the threads here. I could really use any advice I can get. I don't know what to do. I know I would love to run again one day but now I see that I have a good chance of never running again. I am definitely depressed.

I thank y'all in advance for y'all help and I hope you all a speedy recovery.

Sincerely,
Ken

 
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Old 06-10-2012, 10:48 AM   #2
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drew40er HB User
Re: OCD of the Talus

Welcome to the board! I had OCD surgery almost six months ago and in my experience it wasn't that bad of a surgery. I have had problems with my right ankle after years of abuse playing soccer and thought that it was now just a case of old age catching up with me(31 yrs old.....i know, not very old!). I decided to go to an OS to finally get some answers because it was really hindering my workouts for my job(military). Long story short, I had OCD, nickle sized piece of broken ankle bone removed, a bone spur, and torn deltoid ligament reacted. With all that, 4 months after surgery I was given the all clear to slowly start running again.....at 6 months, I am running 3 miles with minor growing pains(I too went from 175 to the 230-240 range), so there is hope that you will be able to get back to your old self, but it is not an easy road and there will be plenty of pain when starting PT. My OS told me that OCD surgery has a 80% success rate, to me that was good enough to go ahead with the surgery. My OS has been very happy with the results and the physical therapist is amazed at how quickly I bounced back, just know that it can be a slow process and that you can have pain for 6 months to a year before your fully healed. Hope this helped and good luck!

 
Old 06-10-2012, 03:50 PM   #3
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KDogg21581 HB User
Re: OCD of the Talus

Hi Drew,

I really appreciate the info on the OCD surgery. It gives me some hope to hear a success story like yours. I am 31 also and know what you mean about old age catching up to you (lol). I hope the OS doesn't have anymore bad news for me than I already have but I think that I'll just go ahead and get this surgery over with. I would like to have more time to build up more sick leave at work (Louisiana Department of Wildlife and Fisheries). If I get told that the OCD has a good chance to grow in size I'll have to get it over with quick no matter if I have the leave or not. Hope you keep having a great recovery!

Thanks again for the info and for your service in the military.

Ken

Last edited by KDogg21581; 06-10-2012 at 03:51 PM.

 
Old 06-11-2012, 06:04 PM   #4
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KDogg21581 HB User
Re: OCD of the Talus

I went to the hospital that I had the MRI done at to get a copy of the results. I needed it for my OS visit next week. Well I got a disk of the actual MRI and a written report of my aliments. It is a little worse than my other doctor told me. The results are as follows:

1. Localized osteochondral defect at the lateral talar dome, with underlying lateral talar dome sclerosis and marrow edema. Localized osteochondral lesion measures 5 X 9 X 5 mm in size. Differential considerations include asymmetric degenerative lateral talar dome wear versus old lateral dome trauma.

2. Old avulsion of the anterior talofibular ligament.

3. Small tibiotalar joint effusion.

These are the actual results of the MRI. So I have more going on than I thought. I guess I'll have to wait and see what the OS will tell me but all this stuff doesn't sound too good. If anyone knows what all this stuff means please let me know.

Thanks for all y'all help and have a speedy recovery.

Ken

Last edited by KDogg21581; 06-11-2012 at 06:06 PM.

 
Old 06-12-2012, 08:33 AM   #5
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BobNAnkle HB UserBobNAnkle HB UserBobNAnkle HB User
Re: OCD of the Talus

Hi Ken,

The OCD is a little bigger than you thought (or you misheard the 9mm for a 5mm). It's on the lateral side of the ankle bone (Talus), which is the outside vs inside of your body.
Bone sclerosis means thickening and edema means swelling in the bone. All of this is due to the OCD, as it's analagous with arthritis, yet in a focal area and not widespread throughout your joint.

Effusion within the ankle joint (between your shin bone the tibia and the ankle bone the talus) is some joint swelling and, again goes along with your OCD condition.

An avulsion is a piece of a bone or ligament that has broken away from its original location and usually due to the injury. That may not be causing you a problem at all and I've been told to leave those alone instead of going on a fishing expedition to find it.

Your OCD is the main culprit and your options are:

1) do nothing
2) microfracture - usually what the Ortho's do as a first pass scope and it will fill the pot hole with scar tissue if it works. The tissue fill is not as good as hyaline cartilage but can provide significant pain relief for lots of folks
3) OATS - They put a plug of bone and cartilage into the pot hole. The donor is either from you (non-weightbearing knee for example) or cadaver. This procedure is much more invasive and usually requires the curring of the ankle bone that sticks out to gain access to the damaged area.
4) Denovo or ACI - transplaning of cartilage cells to the pot hole. These procedures seem promising, especially Denovo where you only need the one operation and sometimes it's a scope at that.

Good luck. Do research and if possible, I would get another opinion from a top rated foot and ankle ortho just to see where you stand. You shouldn't have to rush into the procedure.

-Bob

 
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Old 06-12-2012, 03:59 PM   #6
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KDogg21581 HB User
Re: OCD of the Talus

Hi Bob,

Thanks for breaking all that stuff down for me. It doesn't seem quite so bad now that I know all my problems are just extensions of my OCD. I am going to see what my foot and ankle Ortho tells me on Monday. I have to find out how many OCD's he has repaired successfully and what procedure he would recommend. I also need to see what my insurance will cover. I really appreciate your help and I will be sure to keep you informed on what happens on Monday.

Thanks for the help,

Ken

 
Old 06-13-2012, 12:38 AM   #7
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Re: OCD of the Talus

I second Bob in not rushing into it. Do your research and definitely find out how many of these your doctor has done successfully! You want the best doctor for the job!
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Brostrom-Gould, repair retinaculum, peroneus longus tendon repair, fibular groove deepening for peroneal tendon subluxation- 2/22/12
-Modified Brostrom (failed)- 8/15/01"]

 
Old 06-21-2012, 05:38 PM   #8
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KDogg21581 HB User
Re: OCD of the Talus

Hi everyone,

I went to my O.S. visit on Monday and I might not be as bad off as I thought. The OCD is on the edge of the talus and I have a ligament that needs tightening. My doctor told me OATS was not necessary for this particular OCD and he thinks that I will do very well with just having it cleaned up and drilled via a scope. He says that he is also going to tighten the ligament that I am having trouble with.

I asked him how many of these injuries he has dealt with and what was his success rate. He said he does these procedures all the time and most of his patients have great success with it. I was told that I will be able to walk without pain after it heals and more than likely will be able to go back to running. I also looked at his ratings online and they are fantastic. I feel confident that he will handle my injury in the best way possible.

I go back to his office on July 9th to fill out the paperwork and set the date for my surgery. I am keeping my fingers crossed that everything will of off without a hitch. I'll let y'all know what happens after my visit on the 9th. If anyone has some info about this procedure let me know. Hope everyone is doing well.

Ken

 
Old 06-22-2012, 05:26 AM   #9
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suebob30 HB Usersuebob30 HB User
Re: OCD of the Talus

I hope everything goes well for you. my injury started out the same way yours did but my lession was a little bigger. I had the scope surgery and they cleaned up scar tissue and drilled out the ocd to promote healing. after surgery i had physical therapy for 4weeks and things felt and seemed good till about 2-3 months ago. I went back to see the doctor who did my surgery and he said to either live with the pain and problems or get a second opinion. I go july 2nd for the second opinion. According to the poditrist who found the original problem there is not much healing to the drilling site so he believes I need the oats procedure. And according to everything i have read here and other places the scope procedure only has about a 70% success rate. My original dr said he had wished he had sent me to a poditrist that specialized in ankles, instead of an os for the scope surgery. Althoough the os had done the procedure with success before, he wasn't a good choice because he didin't specialize in this area. So i guess i would suggest that you make sure your os specializes in this area.(foot and Ankle) If not have him refer you to someone who does.

 
Old 06-23-2012, 08:03 PM   #10
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Re: OCD of the Talus

So glad Kdogg that they can just do the drilling (or microfatures) versus the OATS. Much more non-invasive. I have had microfratures 5 years ago and 2 months ago. The first one was for the talus and now with other procedures I had to have microfractures in the tibia. So I am really hooping it works as well this time as it did 5 years ago.

I feel they are having great success with the microfractures and it is a much quicker recovery. Good Luck and keep us posted.

 
Old 06-23-2012, 08:30 PM   #11
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KDogg21581 HB User
Re: OCD of the Talus

Thanks suebob and greatoutlook!

The O.S. I had the appointment with is a highly recommended foot and ankle specialist. I hope the procedure gets me to walk without pain and to hopefully start running again after it is fully healed. I'm glad the microfracture worked so well for you greatoutlook and I hope it will do the same for me. Suebob, I hope everything is going well for you. I promise to keep y'all posted on any changes that come up with the pending operation. I hope y'all are doing well and feeling great. Thanks for y'all help.

Sincerely

Ken

 
Old 06-24-2012, 03:41 PM   #12
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Re: OCD of the Talus

KDOGG--So glad it isn't as bad a sit seems! The microfractures will be way less invasive than OATS! And a scope is less invasive than an open repair although I didn't think they did ligament repairs via scope. Thought they required an open procedure so that is interesting! I don't have much info on the microfractures surgery except what I know of my friend's experiences with it on her knee, but I can tell you a lot about the ligament repair. I've had that done twice for a total of 5 ligaments repaired in the 2 surgeries along with other stuff. What all questions do you have? Glad you feel confident with your doctor and glad he is a foot/ankle OS and highly recommended at that!
__________________
Brostrom-Gould, repair retinaculum, peroneus longus tendon repair, fibular groove deepening for peroneal tendon subluxation- 2/22/12
-Modified Brostrom (failed)- 8/15/01"]

 
Old 06-24-2012, 03:59 PM   #13
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drew40er HB User
Re: OCD of the Talus

Everyone responds differently to microfracture surgery, me personally, it went very well. I am now almost six months out of surgery and am finally able to run any distance I choose(which isn't very far!) without any pain........Now this didn't happen over night and there was a lot of ups and downs. Just try to remember that it takes time! My OS said that I could have pain for at least 6 months post op and possible up to a year, it all just depends on how your body responds. Overall, I looked at my situation as though I had two options..........1.) Do nothing and live with the pain, or 2.) Get surgery and hope it works! Either way, it was time to do something because option 1 wasn't working and trying option 2 could hurt any worse! Good Luck

 
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