This current concepts review from JBJS evaluates the operative options for osteochondral lesions of the talus — a common consequence of ankle sprains and fractures — covering bone-marrow stimulation, autologous and allograft osteochondral transplantation, autologous chondrocyte implantation, and biological adjuncts.
When you see a talar OCD lesion ≤15 mm in a primary surgical candidate, arthroscopic bone-marrow stimulation is your first-line option; when the lesion exceeds 15 mm or is highly cystic, shift your thinking toward autologous osteochondral transplantation, and counsel patients that allograft or ACI is reserved for failed prior procedures or lesions not amenable to standard autograft.
This current concepts review from JBJS evaluates the operative options for osteochondral lesions of the talus — a common consequence of ankle sprains and fractures — covering bone-marrow stimulation, autologous and allograft osteochondral transplantation, autologous chondrocyte implantation, and biological adjuncts.
When you see a talar OCD lesion ≤15 mm in a primary surgical candidate, arthroscopic bone-marrow stimulation is your first-line option; when the lesion exceeds 15 mm or is highly cystic, shift your thinking toward autologous osteochondral transplantation, and counsel patients that allograft or ACI is reserved for failed prior procedures or lesions not amenable to standard autograft.