Conditions & Treatments

Cartilage Damage & Ankle Arthritis

Damage to the cartilage lining the ankle joint can result from a single significant injury, repeated trauma, or the gradual wear of arthritis. Early and accurate treatment of cartilage lesions can slow or prevent progression to full joint arthritis. Dr. Hanson specializes in the full spectrum of ankle cartilage and arthritis care.

Cartilage Damage and Its Consequences

Unlike bone, cartilage has a limited capacity to repair itself. A focal area of cartilage damage, called an osteochondral lesion, can cause significant pain, swelling, and mechanical symptoms in the ankle. If left unaddressed, these lesions can expand and eventually lead to diffuse ankle arthritis.

Ankle arthritis is less common than hip or knee arthritis but can be equally disabling. It most commonly develops after trauma, such as fractures or repeated ankle sprains. Dr. Hanson evaluates cartilage conditions and ankle arthritis at every stage and tailors treatment to the extent of damage, the patient's age, and their activity goals.


Focal Cartilage Damage of the Talus

Osteochondral lesions of the talus (OLT) are focal areas of cartilage and underlying bone damage, typically on the dome of the talus. They are commonly associated with ankle sprains or fractures and may not be immediately apparent on plain X-rays, requiring MRI for diagnosis.

  • Deep ankle pain, often worse with activity
  • Swelling that does not fully resolve after sprains
  • A clicking, catching, or locking sensation in the ankle
  • Stiffness or limited range of motion
  • Pain out of proportion to the severity of the original injury

From Cartilage Repair to Joint Restoration

Non-Surgical
  • Protected weight bearing and activity modification
  • Anti-inflammatory medication
  • Corticosteroid or viscosupplementation injections
  • Bracing and orthotic support
  • Physical therapy
Surgical
  • Ankle arthroscopy with debridement
  • Microfracture stimulation of cartilage healing
  • Osteochondral autograft transfer (OATS)
  • Allograft cartilage restoration
  • Ankle distraction arthroplasty
  • Total ankle replacement
  • Ankle fusion (arthrodesis)

The appropriate treatment for cartilage damage depends on the size and location of the lesion, the patient's age and activity level, and the presence of any underlying alignment issues that may need to be corrected simultaneously.


When the Entire Joint Is Affected

When cartilage damage progresses to the point of diffuse joint involvement, the treatment decision shifts from cartilage preservation to joint restoration or replacement. At this stage, the primary options are total ankle replacement, which preserves motion, and ankle fusion, which permanently eliminates the painful joint. Dr. Hanson will help you understand which option aligns with your anatomy, goals, and long-term expectations.

Learn more about ankle replacement vs. fusion →


Arthroscopy and Joint Expertise

Dr. Hanson has published a technique tip on limiting fluid extravasation during ankle arthroscopy and has extensive experience with arthroscopic treatment of cartilage lesions. His surgical training and research background make him particularly well-suited to evaluate cartilage problems that may have been missed or inadequately treated at initial presentation.

Take the Next Step

Request a Consultation with Dr. Hanson

Dr. Hanson will take time to understand your specific situation, review any prior imaging or records, and give you an honest assessment of all your options including non-surgical approaches.

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