Once the diagnosis has been confirmed, treatment may consist of either non-operative or operative methods. The specifics of treatment will likely depend upon the nature of the OLT, presence of other injuries, and patient characteristics.
Non-operative treatment is appropriate for certain lesions and usually involves immobilization and restricted weight bearing. This may then be followed with gradual progression of weight bearing and physical therapy. The goal of non-operative treatment is to allow the injured cartilage and bone to heal.
Other lesions may be more appropriately treated with surgery. The goals of surgery are to restore the normal shape and gliding surface of the talus in order to re-establish normal mechanics and joint forces. The hope is to minimize symptoms and limit the risk of developing arthritis. Depending on the characteristics and location of the OLT, surgery may done arthroscopically or open. Arthroscopy uses a camera and small instruments to view and work within the joint through small incisions. It may not be possible to properly treat certain lesions arthroscopically due to the size or location of the lesion. Treatments may include debridement (removing injured cartilage and bone), fixation of the injured fragment, microfracture or drilling of the lesion, and/or transfer or grafting of bone and cartilage. Your surgeon and you can discuss these treatment options and decide which one is best for you.