Cochrane Summaries

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Interventions for treating defects of the joint surfaces of the ankle bone in adults

Loveday D, Clifton R, Robinson A
Published Online: 
8 August 2010

Osteochondral defects are limited areas of damage to the lining of a joint. These defects involve the joint surface (chondral) and also the bone underneath the surface (osteo). The ankle is composed of three bones named the tibia (shin bone), fibula (the other lower leg bone) and talus (ankle bone). This review just looks osteochondral defects in the talus. Such defects occur mainly after trauma. They are rare but can result in pain and significant disability.

Treatment can be either by non-surgical or surgical means. Non-surgical interventions include activity restriction, physiotherapy and supplementation of the synovial fluid (the lubricating fluid within a joint). Surgical interventions by keyhole or open surgery aim to regenerate or replace the articular surface of the joint. This review included only one very small randomised trial with 15 participants, all of whom had chronic pain from osteochondral defects in the ankle bone. This trial looked at the effect of injecting hyaluronic acid, a lubricant, into the joint three weeks after surgical repair. However, there was only a brief report of this small and probably biased trial. There were no numerical data to draw conclusions on the effects of the intervention.

Currently there is insufficient evidence from randomised trials to determine which interventions are best for osteochondral defects of the talus in adults.