Question
I was diagnosed with an OCD of my right talar dome in 2005.  I had a synivectomy in 2010 because the surgeon was unable to access the lesion through a scope.  I've found an ortho who accepts my insurance and says he can fix my ankle... but I'm sort of hesitant.  I'm supposed to be having weight loss surgery and will complete the qualifications for it at the end of November, so my surgery should be the end of December or beginning of January.

The ortho says he'll have to cut the medial malleolus, dislocate my ankle, and repair it using drilling and OATS.  He says I'll be non-weight bearing after that until the bone heals, but didn't give me a time range.

How long does it typically take for the medial malleolus to heal sufficiently to allow ambulation in a cam walker after surgeries like this, and is there anything I can do to promote bone healing?

Thanks!

Answer
That is an excellent question, Brian.  OCD lesions can be fixed multiple ways depending on the size of the lesion and the location.  Smaller lesions can be excised or dilled with arthroscopy.   Unfortunately larger lesions, usually greater than one cubic centimeter cannot and the ankle must be opened for removal or graft implantation.  Depending on the surgeon抯 experience and surgical preface, a medial malleolar osteotomy may be needed to have full visualization of the talar dome to identify the OCD lesion and perform an OATS procedure (osteochondral autograft transfer system).  
With that being said, bone healing for a medial malleolar osteotomy in an ideal scenario usually takes about 6-8 weeks complete non-weightbearing to heal properly; however, sometimes it can take longer upward to 10 weeks.  Enhancing bone healing can be done by staying compliant with the non-weightbearing status and smoking cessation if you use tobacco.  Bone stimulators are available as well to enhance bone healing; however, if not covered by insurance they can be very expensive and they are usually used for slow healing fractures or fusions.  Other vitamins and supplements have not shown any solid clinical evidence of enhancing bone healing but having an overall healthy lifestyle is always ideal for healing surgical sites.

Hope this helps!  If you have any other questions, please let me know and I'll help in any way I can.

Dr. Leslie Johnston, DPM
Tampa, FL
Advanced Podiatry

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