Description of patient (type of occupation, indication of age, intensity of sport):
34 years old man.
History and previous treatment:
3 years ago ankle sprain with peroneal fracture treated conservatively. No other treatments on the left ankle.
Current complaints:
Weight bearing persistent deep ankle pain with major limitations also in ADL.
Physical examination:
Minor swelling with no limiations in ankle ROM. No mechanical laxity of the lateral/medial ligamentous complex.
Radiology:
X-ray:
[Picture 1 + 2]
Additional investigation (CT/MRI):
[Picture 3, 4 + 5]
Images:
Case summary:
34 years old man with a postratumatic OCD left ankle.
Question(s) to this case:
In my experience BMS procedure (debridement and microfracture) can be successfull also in defects bigger than the common 1.5 cm2 treshold.
What do you think about this lesion? Is the type of the lesion a contraindication for BMS procedure? What do you alternatively suggest?
Expert:
I agree! The length of the lesion on the sagital CT for me is most important. I would go for microfracture and explain to the patient that the result might be little less than the typical 85% good/excellent result.