Osteochondral lesions of the talus, large or small, present a challenge to the treating orthopaedic surgeon. These cartilage and bony defects can cause substantial pain and functional disability. Surgical treatment of small lesions of the talus has been thoroughly explored and includes retrograde drilling, arthroscopic débridement and marrow stimulation, osteochondral autografting from cartilage/bone unit harvested from the ipsilateral knee (mosaicplasty), and autologous chondrocyte implantation. Although each of these reparative, replacement, or regenerative techniques has various degrees of success, they may be insufficient for the treatment of large osteochondral lesions of the talus. Large-volume osteochondral lesions of the talus (>1.5 cm in diameter or area >150 mm2) often involve sizable portions of the weight-bearing section of the talar dome, medially or laterally. To properly treat these osteochondral lesions of the talus, a fresh structural osteochondral allograft is a viable treatment option.
From the Medical University of South Carolina, Charleston, SC (Dr. Gross) and Duke University Medical Center, Durham, NC (Dr. Adams, Dr. Easley, and Dr. Nunley).
This article, as well as other lectures presented at the Academy’s Annual Meeting, will be available in March 2016 in Instructional Course Lectures, Volume 65.
Dr. Adams or an immediate family member is a member of a speakers’ bureau or has made paid presentations on behalf of Harvest Technologies; serves as a paid consultant to or is an employee of Biomet, Medshape, Medtronic, Regeneration Technologies, and Stryker; and has stock or stock options held in Medshape. Dr. Easley or an immediate family member is a member of a speakers’ bureau or has made paid presentations on behalf of Stryker and Tornier; serves as a paid consultant to or is an employee of DT MedSurg, Exactech, SBI, Tornier, Stryker, and TriMed; serves as an unpaid consultant to Orthofix; has received research or institutional support from Acumed and TriMed; and serves as a board member, owner, officer, or committee member of the American Orthopaedic Foot and Ankle Society. Dr. Nunley or an immediate family member has received royalties from Wright Medical Technology; is a member of a speakers’ bureau or has made paid presentations on behalf of Orthofix; serves as a paid consultant to or is an employee of Exactech, DT MedSurg, Stryker, and Tornier; has stock or stock options held in Bristol-Myers Squibb, Merck, and Johnson & Johnson; and has received research or institutional support from the Orthopaedic Research and Education Foundation, Synthes, Integra LifeSciences, Breg, and Tornier. Neither Dr. Gross nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article.
Received June 11, 2015
Accepted August 06, 2015
