On 23/12, Doctor of Medicine, Level 2, Truong Cong Dung, Director of Sports Medic Clinic, reported that the patient's left ankle had been experiencing a dull ache and mild swelling for about one week. After nearly three continuous hours of playing pickleball, the pain intensified, making walking difficult. He had previously undergone arthroscopic anterior cruciate ligament reconstruction on his right knee and had twisted his ankle multiple times during sports. Since his symptoms usually subsided on their own, he had not sought treatment.

An MRI of the left ankle revealed cartilage and talus bone damage, accompanied by surrounding bone marrow edema. Doctors diagnosed the condition as osteochondritis dissecans of the talus (ankle OCD). This type of injury is common in young people, especially athletes who engage in repetitive ankle rotations, jumping, and sudden changes in direction.

According to Dr. Dung, the talus is the main weight-bearing structure of the ankle joint but has poor blood supply. When the articular cartilage and the subchondral bone layer are damaged, the healing potential is limited. If not detected and treated promptly, the joint surface can be destroyed and progress to early osteoarthritis. In severe cases, cartilage-bone fragments may detach and float within the joint, causing sudden locking or catching of the joint, significant pain after activity, and a crunching sound during movement. At that stage, the damage is almost irreversible.

"For individuals who regularly play sports, this type of injury leads to ankle instability, reduced balance, and difficulty running fast, jumping, or maintaining high-intensity activity," Dr. Dung said. He added that many cases require individuals to stop playing sports or face early joint degeneration if treatment is delayed.

The patient underwent autologous osteochondral transplantation (OATS) surgery to address the talus injury. This technique involves taking a cartilage-bone graft from a less weight-bearing area, typically the knee joint, and transplanting it to the damaged region to restore the ankle joint surface. After surgery, the swelling and pain decreased, and the patient is currently learning to walk with crutches while continuing follow-up and rehabilitation.

Doctor of Medicine, Level 2, Truong Cong Dung and his surgical team operating on a patient. *Photo: Doctor provided*

Doctors advise athletes not to be complacent about ankle injuries, especially if they have a history of recurrent ankle twists and persistent pain after physical activity. Mild pain and swelling do not necessarily indicate minor damage; timely specialized examination and diagnostic imaging are crucial for long-term preservation of ankle joint function.

Le Phuong