Medial talar OCD post drilling

Osteochondral Defects

Description of patient (type of occupation, indication of age, intensity of sport):

Young, patient 36 years old, very active, polio sequellae left but minor, did body pump until his injury few months ago. Since then crutches.

History and previous treatment:

End of last year injury to ankle with diagnosis of medial OC talar lesion treated with arthroscopy and drilling.

Current complaints:

Continuous pain medially in ankle, swelling, needs crutches to walk.

Physical examination:

Slightly swollen ankle, painful medial deep, ROM 20/0/20, weightbearing very difficult due to pain, good alignment lower legs, varus heel alignment.


[Picture 1]

Additional investigation (CT/MRI):
[Picture 2]


Case summary:

Medial talar OC lesion post drilling with heel varus due to polio with minor neurologic implications.

Question(s) to this case:

Slide osteotomy calcaneus, to combine with distal tibia?


I miss the AP standing X-Ray. I would advise a CT to see if there are other reasons for the pain (loose bodies etc). Then probably lateralizing sliding calcaneal osteotomy 7.5-10 mm.