Post-Operative Care for Osteochondritis Dissecans in Ankle Surgery

Q: Post-Operative Care for Osteochondritis Dissecans in Ankle Surgery

Hello： Based on your description, it appears that you may have osteochondritis dissecans of the talus and have undergone a bone marrow stimulation procedure. <br>Currently, there is still significant swelling. <br>Since it has been approximately three weeks post-surgery, in addit

Postoperative Issues Following Arthroscopy for Osteochondritis Dissecans of the Ankle

Hello, doctor.
I have been practicing karate since I was 11 years old and continued until I graduated from college.
Recently, I experienced sudden severe pain in my left ankle, which prevented me from getting out of bed, so I sought medical attention.
After X-rays, an MRI, and the physician's assessment, I underwent arthroscopic surgery.
The treatment plan involved removing a nearly two-centimeter piece of detached cartilage and drilling a hole at the talus to allow stem cells to grow into cartilage.
PRP was not used during the surgery.
Postoperatively, I have not put weight on my left foot and have been using two crutches for ambulation.
Today marks the 17th day post-surgery, and my left foot is still very swollen, numb, and has dark purple bruising on the dorsum, accompanied by pain in the ankle area.
I would like to ask the doctor how else I can care for my condition besides elevating the affected limb.
Additionally, since I did not use a cast or any supportive devices, should I wear an ankle brace? Thank you for taking the time to respond.

Niming, 20~29 year old female. Ask Date: 2019/06/13

Dr. You Dianqi reply Orthopedics

Hello: Based on your description, it appears that you may have osteochondritis dissecans of the talus and have undergone a bone marrow stimulation procedure.
Currently, there is still significant swelling.
Since it has been approximately three weeks post-surgery, in addition to elevating the affected limb, I believe that if there is no ongoing increase in swelling, applying some warm compresses to promote blood circulation could also be beneficial.
As for the ankle brace, since you have not yet returned to the field, its primary role would be to provide mild compression to reduce swelling.
This should be tailored to your protective gear and your body's response, and it is not an absolute necessity.
Wishing you a speedy recovery.

Reply Date: 2019/06/13

More Info

Post-operative care for osteochondritis dissecans (OCD) following ankle surgery is crucial for optimal recovery and long-term joint health. Given your history of karate and the recent surgical intervention to address the cartilage issue in your ankle, it’s important to follow a structured rehabilitation plan while being mindful of your symptoms.

Firstly, the swelling, bruising, and pain you are experiencing 17 days post-surgery are not uncommon. After such procedures, it is typical for the body to respond with inflammation as part of the healing process. However, persistent swelling and pain can indicate that your body is still adjusting to the surgical changes. Here are some recommendations for your post-operative care:
1. Elevation and Rest: Continue to keep your affected leg elevated as much as possible. This helps reduce swelling and promotes blood circulation. Rest is equally important; avoid putting weight on the affected ankle until your doctor advises otherwise.

2. Ice Therapy: Applying ice packs to the swollen area can help alleviate pain and reduce swelling. Make sure to wrap the ice pack in a cloth to prevent frostbite, and apply it for 15-20 minutes every couple of hours as needed.

3. Compression: If your doctor has not advised against it, consider using a compression bandage to help manage swelling. This can provide support and may help reduce the accumulation of fluid in the area.

4. Pain Management: Continue to manage your pain with prescribed medications. If you find that your current pain management plan is insufficient, consult your physician for alternatives or adjustments.

5. Physical Therapy: Once your doctor gives the green light, engaging in physical therapy will be essential. A physical therapist can guide you through exercises that promote mobility, strength, and stability in your ankle. This is particularly important after cartilage removal and drilling for stem cell growth, as it helps ensure proper healing and function.

6. Use of Ankle Brace: Given that you did not use a cast or rigid support post-surgery, wearing an ankle brace or support can be beneficial. An ankle brace can provide stability and protection as you begin to regain strength and mobility. It can also help prevent further injury during the healing process.

7. Monitoring Symptoms: Keep a close eye on your symptoms. If you notice increased pain, swelling, or any signs of infection (such as redness, warmth, or discharge), contact your healthcare provider immediately.

8. Gradual Weight Bearing: As you progress, your doctor will likely provide a timeline for when you can start bearing weight on your ankle. It’s crucial to follow their guidance to avoid complications.

9. Follow-Up Appointments: Ensure you attend all follow-up appointments with your surgeon. They will monitor your healing process and make necessary adjustments to your rehabilitation plan.

In summary, while your current symptoms are concerning, they are not unusual for the post-operative phase following OCD surgery. Focus on rest, elevation, ice, and gradual rehabilitation. Wearing an ankle brace can provide additional support, and be sure to maintain open communication with your healthcare team regarding your recovery. With proper care and adherence to your rehabilitation plan, you can expect to regain function in your ankle over time.

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