Arthroscopic-Assisted Osteochondral Allograft Transplantation for Posterolateral Lesions of the Talus Without Fibular Osteotomy

Abstract

Osteochondral lesions of the talus are chondral defects often caused by acute trauma to the ankle such as sprains and fractures. If operative treatment is necessary, microfracture, cartilage replacement, and autologous chondrocyte implantation can be used. We describe a single-step osteochondral allograft transfer to access the posterolateral talar dome that avoids the need for a fibular osteotomy and therefore eliminates morbidity while reducing operative time.

Posteromedial Approach for Osteochondral Lesions of the Talus

“…24 As a general rule, talar osteochondral lesions that do not respond to conservative treatment are treated with surgical methods. 24 The decision to repair or replace is made in consideration of the lesion size. Lesions less than 1.5 cm 2 are generally treated by reparative procedures, whereas replacement techniques are often used in lesions larger than 1.5 cm 2 .…”

“…Natural cartilage repair is limited due to the avascular nature of the articular cartilage. 24 As a general rule, talar osteochondral lesions that do not respond to conservative treatment are treated with surgical methods. 24 The decision to repair or replace is made in consideration of the lesion size.…”