Osteochondral Lesions of the Talar Dome: Osteochondral Autologous Transplantation Treatment

Abstract

Osteochondral autologous transplantation (OAT) is a restorative procedure that substitutes the pathology with viable hyaline cartilage and subchondral bone as a whole unit.1 For this reason, OAT has been an appealing option for osteochondral lesions of the talus (OLT) with a large size, cystic lesions, and failed bone marrow stimulation procedures (Figure 3-1). The concept of cartilage and bone unit transplantation was first reported by Wagner 2 to treat osteochondritis dissecans of the knee. OAT was then developed using multiple plugs in the knee, and favorable short- to mid-term outcome was reported.3 Upon the success of OAT in the knee, the technique was applied to the ankle. In a preliminary report of a prospective study, Hangody et al 4 first reported OAT for the OLT in 11 patients. The promising results of this study were followed by several similar results with short- to mid-term outcomes.1, 5-8 However, previous reports lack long-term results and a high level of evidence.9 Also, further concerns regarding donor site morbidity have increased because the technique involves the normal knee as a donor.10,11. © 2016 by Arthroscopy Association of North America (AANA).