Ankle articular cartilage damage
Cartilage damage most often occurs after an ankle sprain.
These are focal injuries, which may be accompanied by fractures of the bone directly beneath the damaged cartilage.
40% of ankle sprains are complicated by cartilage damage
Missed and untreated cartilage damage can lead to degenerative changes in the ankle joint
In young athletes, injuries may develop after many imperceptible microtraumas
01
Symptoms
- Pain during or immediately after sports activity. The pain is felt deep inside, ‘somewhere in the joint’
- Limited range of motion in the joint
- Intermittent swelling
02
Diagnostics
- X-rays taken in 3 projections
- Magnetic resonance imaging (MRI) and/or computed tomography (CT) is necessary
03
Conservative treatment
Conservative treatment uses physical procedures such as magnetic fields, laser therapy, ultrasound and physiotherapy. Treatment is symptomatic and not very effective.
04
Surgical treatment
- The microfracture technique involves preparing the floor of the defect and then making several small holes in it to fill the defect with multipotent bone-marrow cells.
- Covering the defect with a collagen or cross-linked hyaluronic-acid membrane and filling it with stem cells or platelet-rich plasma (PRP)
- Bone grafts to fill deep defects
- Combination of the techniques mentioned above
05
Postoperative management
- After the procedure, the patient walks on elbow crutches while keeping weight off the operated limb
- The ankle is immobilized in an orthosis or plaster splint
- During the postoperative period, anticoagulant, pain-relieving and anti-swelling medication is necessary
- All patients who undergo surgical treatment for articular-cartilage injuries receive rehabilitation according to an individual exercise programme
