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Most talar cartilage injuries have a traumatic pathogenesis. They occur as a result of a single or repeated traumatic event. Initially only the cartilage may be damaged by shear stress and may heal, remaining asymptomatic. Often the trauma causes microfractures in the subchondral plate and bone and upon loading, water is forced into the damaged subchondral area by the compressed cartilage, leading to a localized increased flow and fluid pressure. This can cause osteolysis and lead to the formation of subchondral cysts. Deep ankle pain on weight bearing, most probably caused by repetitive high fluid pressure will limit the patients mobility and hence quality of life and needs to be treated.
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