Description of patient (type of occupation, indication of age, intensity of sport):
39 year old engineer. Active and healthy.
History and previous treatment:
4 years ago diagnosis of OCD medial talus left ankle. Arthroscopy with debridement and drilling done including ATFL repair. Fine after surgery. Did sports again including running.
Current complaints:
Pain left ankle. Started a few months ago. No trauma.
Physical examination:
Left ankle mild swelling. Normal axis. General Hypermobility. Same stability right and left ankle.
Radiology:
X-ray:
[Picture 1]
Normal ankle, no deformity.
Additional investigation (CT/MRI)
[Picture 2 + 3]
Images:
Case summary:
Reoccurance OCD medial talus, status after arthroscopic debridement and drilling 4 years ago.
Question(s) to this case:
What to do:
1) Wait and see?
2) Arthroscopy?
3) OAT?
4) AMIC?
Expert:
I would go for a second debridement and BMS. The reason is the fragment which is still in place.
The chance for a good result is 75%.