AVN of Talus

[lomdon43]

I would like to know your openion about progression of AVN of Talus due to an injury. AVN developed 4 to 5 years ago, and bone decompression did not help the pain.  For the last couple of years AVN dimensions has not changed, is it possible/common that it could get worse? or is it pretty safe to assume it will stay the same as one ages?
Also I understand that joint fusion is neither a good option, nor in many cases will work.  

[Michael L Gross, MD]

Even if the appearance of AVN has not changed over the last several years, if it has not resolved, it can always get worse. A change in activity, or a second trauma would certainly put you at risk; even a sudden increase in weight could be a risk.
As far as tibotalar fusion, I think you have been misinformed. The fusions can be very successful, at times they can be done arthroscopically, and often do not limit activity. Another option, that has recently become more reliable, is ankle replacement surgery.
For a further review, I would suggest an evaluation by an orthopedic foot and ankle specialist.

[Michael L Gross, MD]

If the pain is manageable, and the AVN is not getting worse, then observation is always an option

[lomdon43]

I have seen several Orthopedic Surgeons and opinions vary.  One says, ankle replacement is not possible due to AVN, and recommends placing additional cartilage.  Another says Bone Graft is what I should try depending on the pain level.  As long as the pain is manageable and I am being careful with it, is it necessary that I undergo a bone graft sooner? Or is it okay to leave it alone for now?