Poor mental health is highly prevalent in patients with OLT, with scores substantially lower than the general population and comparable with individuals with mood or anxiety disorders, and despite successful long-term clinical outcomes of treatment, mental health remained poor.
The vast majority of OLT patients scored at or below the threshold for poor mental health on the MHI-5 scale.
OLT patients scored significantly lower on the MHI-5 than the general Dutch population.
OLT patients had mental health scores comparable to individuals with mood or anxiety disorders.
Poor mental health persisted in the majority of OLT patients one and two years after treatment.
Smoking and ankle pain (FAOS pain score) were independently associated with worse mental health in OLT patients.
This research suggests that people who have osteochondral lesions of the talus (OLT) — a type of cartilage and bone damage in the ankle — experience very poor mental health. The study compared nearly 360 OLT patients to the general Dutch population and to people diagnosed with mood or anxiety disorders. It found that OLT patients scored dramatically lower on a standard mental health questionnaire than the general public, and their scores were statistically similar to those of people with diagnosed mood or anxiety disorders. About 87% of OLT patients fell below the threshold indicating poor mental health before receiving treatment. Perhaps most striking, poor mental health did not go away after treatment. Even one and two years after receiving care for their ankle condition — with treatment generally considered clinically successful — approximately 78–79% of patients still had poor mental health scores. The study also found that smoking and greater ankle pain were both independently linked to worse mental health, while factors like age, sex, body weight, or the specific nature of the ankle lesion were not significantly associated. This research suggests that treating the physical ankle problem alone may not be enough to address the full burden of illness experienced by OLT patients. The findings highlight the potential importance of also screening for and addressing mental health needs in people being treated for this orthopedic condition, rather than assuming that fixing the ankle injury will automatically improve patients' overall wellbeing.
Pijnacker J, Agyeman-Prempeh N, Sierevelt I, Emanuel K, Broekman B, Kerkhoffs G, et al.. (2026). Poor mental health in patients with symptomatic osteochondral lesions of the talus.. The bone & joint journal. https://doi.org/10.1302/0301-620X.108B9.BJJ-2025-1851.R1