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OD OSG and Arthrosis

I am 30 years old and have been suffering from osteochondritis dissecans in both ankles since my youth. The right ankle is now symptom-free. The left ankle underwent surgery in 2011 (retrograde drilling), Microfracture surgery with ligamentoplasty in 2012, and AMIC with spongioplasty and osteotomy in 2014. Since the surgery in 2014, I was symptom-free for a long time. However, since my pregnancy 1.5 years ago, I have been experiencing strong issues again. Morning stiffness, a constantly swollen foot, loud cracking noises, and intense pain during activity with days of pain after exertion. Today, the first MRI since the surgery in 2014 took place.

How would you classify my medical history and the findings? Is it even worth trying conservative treatment? After all, the arthritis developed despite ligamentoplasty and osteotomy. Or have all surgical methods been exhausted and should no further surgery be considered?

I have a young son and I am relatively young myself. I do not want to live the rest of my life with such severe limitations. I would greatly appreciate your assessment. Warm regards, Kim Neef

MD Felix Aaslepp

Hello,

please excuse my delayed response due to my vacation. Thank you for the detailed description and findings.
Your medical history is already quite extensive and several surgical procedures have been performed. Therefore, the answer is not simple. The MRI shows a significant deterioration compared to the previous findings, and especially significant cysts, which are actually an indication for surgery as they lead to instability. However, several different surgical measures have already been performed and any further ones are difficult and should be carefully considered. Considering your young age, another operation should definitely be considered. The complexity of a repeat surgery and the associated risks must be carefully weighed against the potential success.

I would recommend that you present yourself at a suitable orthopedic center for OD or ankle surgeries with all previous findings and documents from prior surgeries and discuss the therapy options with the colleagues there. You can already implement accompanying conservative measures.

I wish you all the best!

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Experte für Orthopedics

MD Felix Aaslepp

MD Felix Aaslepp

Aachen

Felix Aaslepp, MD.
Studium der Humanmedizin in Budapest, Kiel und Köln. Approbation als Arzt (MD) verliehen von der Bezirksregierung Köln. Praktisches Jahr in der Chirurgie, inneren Medizin und Gynäkologie. Klinische Tätigkeit in der Unfall-, Viszeral-, Gefäß- und Thoraxchirurgie sowie Versorgung orthopädischer Patienten. Weiterbildung in Intensiv- und Notfallmedizin (Notarzt). Erwerb Fachkunde Strahlenschutz/Röntgendiagnostik. Klinische Forschung in der Kinderanästhesie und Kinderherzchirurgie. Tätigkeit als medizinischer Experte in der pharmazeutischen Industrie. Freiberufliche Ernährungs- und Sportberatung.

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