Affiliations: Department of Physiotherapy, Faculty of Education and Health Science, University of Limerick, Limerick
Note:  Corresponding author. Neasa De Burca, Department of Physiotherapy, Faculty of Education and Health Science, University of Limerick, Limerick and Physiotherapy Department, University Hospital Galway, Galway. Email: [email protected]
Abstract: This paper reviews the current literature on osteochondral lesions (OLT) of traumatic origin. These injuries can be classified into five stages, and the mechanism of injury will differ depending on whether the lesion is located anterolaterally or posteromedially. Clinically, patients may present with an OLT masked by the features of an acute ankle sprain. Typically however, patients present with chronic ankle pain along with intermittent swelling and possibly weakness, stiffness, instability, or giving way and are often missed on initial presentation. Investigations will include plain radiographs and MRI. Whether to treat conservatively or operatively depends on the stage of the lesion, the duration of symptoms and the age of the patient. Short term results of OLT are good, but long term follow up has found 50% of patients with OLT showed degeneration of the joint. In summary, it is important to consider the possibility of OLT when confronted with a patient with an ankle injury who, despite adequate rehabilitation has not progressed satisfactorily. The key to good long term prognosis from OLT is early diagnosis and treatment.