Background: Osteochondral lesions of the ankle (OLA) often occur in athletes, necessitating a focus on sport outcomes such as return to sports (RTS) and return to performance (RTP). Only a few studies have evaluated sports outcomes after treatment of an osteochondral lesion in the athletic population, let alone in an elite athlete population. Purpose: To assess RTS and RTP rates and times after treatment of OLA in elite athletes. Study Design: Case series; Level of evidence, 4. Methods: All elite athletes treated for an OLA were selected from a cross-sectional database consisting of consecutive patients with cartilage injuries of the ankle until August 2022. Outcomes included RTS outcomes, patient-reported outcomes, and a quantitative assessment regarding mental health. Results: A total of 25 patients, with a median age of 22 years (interquartile range [IQR], 19-25 years), were included, with a median follow-up time of 48 months (IQR, 35-71 months). Six patients (24%) underwent nonoperative treatment, and 19 patients (76%) underwent operative treatment. Nonoperative treatment yielded RTS rates of 83% at any level, 67% at the preinjury level, and 67% for RTP. For operative treatment, these rates were 100%, 74%, and 63%, respectively. The median time to return to preinjury level was 7.5 months overall. Conclusion: The different treatment options for OLAs allowed for adequate RTS and RTP outcomes. Overall, an RTS rate of 96% at any level, a return to the preinjury level of 72%, and an RTP of 64% were found. These sport-specific outcomes can inform athletes about their expected outcomes after different treatments for OLAs.
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