What is the typical postoperative protocol after retrograde drilling of an osteochondral defect in the ankle?

• A. Early post-op motion with limited weightbearing in boot for 6 weeks
• B. Immobilization in a long leg cast for 12 weeks
• C. Non-weight bearing for 12 weeks
• D. Immediate full weight bearing in a shoe

Answer: (A)

After retrograde drilling of an ankle osteochondral defect, the goal is to protect the healing channels while preserving ankle motion to prevent stiffness. The typical plan is to allow early movement in a controlled way, but keep weight bearing limited for several weeks. Using a walking boot supports gentle ankle range of motion while restricting loading, usually progressing from partial to full weight bearing over about six weeks. This approach supports fibrovascular healing from underneath the lesion without unnecessary immobilization.

Immobilizing in a long leg cast for 12 weeks would overly limit motion and stiffness recovery. Non-weight bearing for 12 weeks is too prolonged and can impair muscle strength and joint mobility. Immediate full weight bearing would place too much stress on the drilling sites and could jeopardize graft integration and healing.