Osteochondritis Dissecans (OCD) of the Ankle

What is an ankle OCD?

Osteochondritis dissecans (OCD) is a condition that can cause a small segment of bone to die in the ankle. The bone can crack away or break off from the rest of the ankle joint because it is not getting enough blood.

OCD can be stable, unstable, or completely float away from the ankle joint as a loose bone part in the joint.

OCD in the ankle usually is caused by a combination of poor blood supply, constant ankle movement, and many ankle injuries. OCD can run in families. Obesity may also play a role for some patients. OCD can happen on either ankle.

In younger patients, the cracked or fractured bone and cartilage is more likely to heal on its own. In older children and young adults, OCD has a lower chance of healing without treatment or surgery.

How do you diagnose ankle OCD?

The physician will discuss the patient’s medical history as well as how and when the injury occurred. The next step will be a physical examination that will look for:

• Tenderness
• How the ankle moves
• Swelling
• Ankle catching or clicking
• Abnormal walking movement

Tests

X-rays: A scan that allows the provider to see an OCD opening and understand the size and location inside the ankle.

MRI (Magnetic Resonance Imaging): This type of image gives the provider more detail about the OCD and if the loose piece of bone is attached or is loose.  

What is the treatment for an ankle OCD?

If the patient is young and the OCD opening can possibly heal on its own. The non-surgical treatment includes:

• Rest
• Activities that do not cause impact on the ankle
• A cast or a walking boot to control ankle movement
• Crutches
• Physical therapy

Surgical treatment is used if other treatments fail. After surgery, the patient needs to use crutches for about 6 weeks. Physical therapy will improve ankle motion and help rebuild the ankle strength after surgery. Returning to sports or other activities after OCD surgery could take 4 to 6 months.