An osteochondral lesion (“OCL”) is the name given to an area of damaged cartilage inside the ankle, usually arising following a severe ankle sprain or fracture. OCLs can occur in other joints, most notably the knee.

OCLs are very rarely diagnosed immediately, but are one possible reason for a failure to recover from an ankle injury. Typically at the time of injury, there is a large amount of swelling, and it may not be possible to bear weight on the foot for days or even weeks. Patients with an OCL may complain of persistent swelling and pain inside the ankle beyond six weeks after the injury.

OCLs come in different sizes, degrees of severity and locations within the ankle. A CT or MRI scan is usually required both to diagnose a lesion and determine its characteristics.

If a lesion is associated with significant symptoms, surgery is usually required. The nature of the surgery will vary, depending on the individual lesion, but usually involves an ankle arthroscopy. More complex or recurrent lesions may require more complex surgery, and sometimes other procedures are necessary at the same time, such as lateral ligament reconstruction.

Post-operative rehabilitation is very important after surgery for OCL, and return to sport is slower than other ankle injuries. The success rate for surgery is 70-80%.