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NHS Tayside

Ankle Osteochondral Lesion

Who to refer

No improvement with conservative measures at three months and persistent pain and would consider surgical fusion.

How to refer

SCI Gateway/Orthopaedics/Foot & Ankle Service.

Referral will be vetted by an AHP and directed to the most appropriate healthcare professional.

Information to include when referring

Duration and any cause of symptoms
Site/spread of pain. Constant or intermittent symptoms. Disturbing sleep?
Treatment to date (injection, orthotics, any podiatry, physiotherapy)
BMI
Range of movement, effect on walking and activities, any walking aid?
X-ray results (AP and lateral standing).

General information

Can be talocrural, subtalar or midfoot.

Symptoms and signs

Complains of swelling, catching, locking. Pain and stiffness.
Local tenderness
Loss of medial longitudinal arch
Reduced ability or increased pain on moving or weight bearing.

Primary Care management

Advise 'extra width' footwear.
Weight loss, walking aids, analgesia, NSAIDs as appropriate.
X-Ray AP lateral and standing views (if will alter management).

Useful resources

Ankle arthritis patient leaflet