J Korean Foot Ankle Soc.  2020 Jun;24(2):55-60. 10.14193/jkfas.2020.24.2.55.

Osteochondral Lesions of the Talus: Autologous Osteochondral Transplantation

• Bae SY

• KMID: 2502910
• DOI: http://doi.org/10.14193/jkfas.2020.24.2.55

Abstract

Among the various surgical treatment methods for osteochondral lesions of the talus, autologous osteochondral transplantation (AOT) is a useful procedure in cases of a large defect, subchondral cyst, and failed primary bone marrow stimulation procedure. Although bone marrow stimulation alone may not regenerate the damaged plate sufficiently, AOT has the advantage of being able to replace the subchondral bone plate and cartilage with a new one at a same time. Nevertheless, postoperative cyst formation or pain may persist and donor site morbidity is still a limitation of AOT.

Keyword

Talus; Osteochondral lesion; Autologous osteochondral transplantation

Figure

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  Figure. 1 Approach of talar dome. Central to posterior talar dome cannot be accessed with any approach even though osteotomies such as medial malleolar osteotomy (MMO), lateral malleolar osteotomy (LMO), and Chaput osteotomy (CO) can make better access than arthrotomies. PMA: posteromedial arthrotomy, AMA: anteromedial arthrotomy, PLA: posterolateral arthrotomy, ALA: anterolateral arthrotomy.

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  Figure. 2 Several types of tibial osteotomy can be used.

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  Figure. 3 (A) Medial malleolar osteotomy fragment was slightly migrated proximally by two oblique screws secured before than transverse one. (B) Proximal migration can be prevented if transverse screws are secured first.

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