A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). “Osteo” means bone and “chondral” refers to cartilage.

Talar dome lesions are usually caused by an injury, such as an ankle sprain. If the cartilage does not heal properly following the injury, it softens and begins to break off. Sometimes a broken piece of the damaged cartilage and bone will float in the ankle.

Symptoms:

Unless the injury is extensive, it may take months, a year or even longer for symptoms to develop. The signs and symptoms of a talar dome lesion may include:

• Chronic pain deep in the ankle—typically worse when bearing weight on the foot (especially during sports) and less when resting
• An occasional clicking or catching feeling in the ankle when walking
• A sensation of the ankle locking or giving out
• Episodes of swelling of the ankle—occurring when bearing weight and subsiding when at rest

Treatments may include debridement (removing injured cartilage and bone), fixation of the injured fragment, microfracture or drilling of the lesion, and/or transfer or grafting of bone and cartilage. You and your orthopaedic foot and ankle surgeon can discuss these treatment options and decide which one is best.