Ankle Cartilage Injuries

Cartilage injuries in the ankle, also known as osteochondral lesions of the talus (OLT), are a common cause of chronic ankle pain, particularly following trauma such as a sprained ankle.

These injuries affect the smooth cartilage surface that lines the joint, and if left untreated, they can lead to persistent discomfort, reduced mobility, and eventually ankle arthritis.

At Perth Orthopaedic & Sports Medicine, Dr Daniel Meyerkort offers both non-surgical and surgical treatments for ankle cartilage lesions, including advanced procedures like ankle arthroscopy, microfracture, and the OATS (Osteochondral Autograft Transfer System) technique.

This article provides a detailed overview of ankle cartilage injuries, their symptoms, diagnosis, and evidence-based treatment options available in Perth.

What Are Ankle Cartilage Lesions?

Ankle cartilage lesions typically involve damage to the cartilage and underlying bone of the talus (one of the major bones in the ankle joint). These injuries often occur due to trauma, such as an ankle sprain, fracture, or repeated impact from sports. In some cases, they may also be due to genetic or vascular causes.

Symptoms

Common symptoms of ankle cartilage lesions include:

  • Chronic ankle pain, especially with weight-bearing

  • Swelling and stiffness

  • A catching or locking sensation

  • Instability or weakness in the ankle

  • Difficulty returning to sport or physical activity

Diagnosing Ankle Cartilage Injuries

Early and accurate diagnosis is essential to prevent further joint damage. At Perth Orthopaedic & Sports Medicine, Dr Daniel Meyerkort uses a combination of clinical examination, X-rays, and MRI scans to assess the size, depth, and location of cartilage lesions.

An MRI provides a clear view of cartilage integrity and can detect associated bone bruising or cysts, while weight-bearing X-rays help assess the alignment of the ankle and any signs of early arthritis.

Non-Surgical Treatment Options

In many cases, especially when the lesion is small or non-displaced, non-operative management is the first step.

Physiotherapy

A structured rehabilitation program focusing on ankle stability, strength, and proprioception can relieve symptoms and prevent further injury. Local physiotherapists in Perth and regional WA can collaborate with Dr Meyerkort to provide guided exercise therapy.

Activity Modification

Reducing high-impact activities and switching to low-impact exercise such as swimming or cycling can reduce stress on the joint and relieve symptoms.

Bracing or Orthotics

Custom-made ankle braces or orthotics can support joint alignment, particularly in patients with biomechanical issues like flat feet or hindfoot malalignment.

Medications

Anti-inflammatory medications or corticosteroid injections may help reduce pain and swelling temporarily but do not repair cartilage damage.

Surgical Treatment Options

If conservative measures fail or the lesion is large or unstable, surgical treatment may be recommended. Dr Daniel Meyerkort specialises in minimally invasive ankle arthroscopy, which allows for both diagnosis and treatment in a single procedure.

1. Ankle Arthroscopy

Ankle arthroscopy is a keyhole surgical technique used to access the joint with minimal tissue damage. Through two small incisions, a camera and instruments are inserted into the ankle to assess and treat the lesion.

Benefits:

  • Minimally invasive

  • Short recovery time

  • Reduced risk of complications

  • Suitable for both diagnosis and treatment

Ankle arthroscopy can be used for debridement (cleaning up damaged cartilage), microfracture, or to assess the extent of cartilage loss.

2. Microfracture Procedure

The microfracture technique is commonly used for small to moderate-sized lesions. During arthroscopy, small holes are drilled into the bone beneath the damaged cartilage to stimulate a healing response. This process encourages the formation of fibrocartilage, which fills the defect.

Benefits:

  • Minimally invasive

  • Promotes healing using the body’s natural response

  • Quick return to daily activities

Risks and limitations:

  • Fibrocartilage is not as durable as natural hyaline cartilage

  • Best suited for small defects in low-demand patients

  • Some risk of re-injury or symptom recurrence over time

3. OATS Procedure (Osteochondral Autograft Transfer System)

For larger or more complex cartilage lesions, the OATS procedure may be recommended. This involves transplanting a plug of healthy cartilage and bone from a non-weight-bearing area of the knee to the damaged area of the ankle.

Benefits:

  • Replaces damaged tissue with durable, hyaline cartilage

  • Effective for moderate-to-large defects

  • High success rates in active individuals

Risks and considerations:

  • More invasive than microfracture

  • Potential donor site morbidity in the knee

  • Longer recovery and rehabilitation period

Dr Meyerkort has significant experience performing OATS procedures in carefully selected patients, particularly athletes and active individuals requiring durable outcomes.

Postoperative Recovery & Rehabilitation

Postoperative care is a crucial aspect of treatment success. Recovery protocols are tailored based on the surgical technique used and lesion size.

Typical Recovery Timeline:

  • Arthroscopy/microfracture: Non-weight-bearing for 4–6 weeks, gradual return to sport at 3–6 months

  • OATS procedure: Non-weight-bearing for 6–8 weeks, return to full activity at 6–9 months

Rehabilitation is guided by your surgeon and physiotherapist. Perth Orthopaedic & Sports Medicine offers coordinated care to ensure a smooth recovery, including Telehealth consultations for regional WA patients.

Risks of Surgical Treatment

Like any surgical procedure, treatment for ankle cartilage lesions involves some risk. These may include:

  • Infection

  • Nerve irritation or numbness

  • Blood clots

  • Stiffness or ongoing pain

  • Failure of the cartilage repair

However, with careful patient selection and expert surgical technique, these risks are minimised. Dr Meyerkort uses the latest evidence-based methods to optimise outcomes for each patient.

Why Choose Dr Daniel Meyerkort in Perth?

As an experienced orthopaedic surgeon specialising in sports ankle injuries, Dr Daniel Meyerkort provides tailored treatment plans based on each patient’s needs, activity level, and goals. Whether you're an athlete looking to return to sport or someone with chronic ankle pain, treatment options are available to restore function and reduce pain.

Dr Meyerkort consults at Perth Orthopaedic & Sports Medicine and regularly assists patients from across Western Australia, offering Telehealth appointments, expedited MRI referrals, and close collaboration with your local physiotherapist.

Personalised Orthopaedic Care in Perth

If you're suffering from persistent ankle pain or have been diagnosed with an ankle cartilage lesion, early intervention can help prevent further joint damage. Call (08) 9212 4200 or visit www.perthortho.com.au to book a consultation with Dr Daniel Meyerkort at Perth Orthopaedic & Sports Medicine.