The Journal of Bone and Joint Surgery (American). 2010;92:1774-1779.
doi:10.2106/JBJS.I.01470
© 2010 The Journal of Bone and Joint Surgery, Inc.
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Treatment of Osteochondral Lesions of the Talus with a Biosynthetic Scaffold

A Report of Four Cases

E'Stephan J. Garcia, MD1, Russell R. Bear, DO1, Andrew J. Schoenfeld, MD1 and Brett D. Owens, MD2

1 Department of Orthopaedic Surgery, William Beaumont Army Medical Center, Texas Tech University Health Sciences Center, 5005 North Piedras Street, El Paso, TX 79920. E-mail address for E.J. Garcia: estephan.garcia@amedd.army.mil
2 Department of Orthopaedic Surgery, Keller Army Community Hospital, 900 Washington Road, West Point, NY 10996-1197

The first 150 words of the full text of this article appear below.


   Introduction
 
The management of recurrent and large cystic osteochondral lesions of the talus presents a challenge to orthopaedic surgeons. Although numerous treatment options are available, few publications exist that provide guidance regarding management. The initial management of stage-I and stage-II lesions1,2 is typically nonoperative. However, for persistent or advanced talar lesions, surgical intervention is common3-5. Surgical options traditionally include arthroscopic debridement with or without microfracture, internal fixation of larger fragments, or retrograde drilling with bone-grafting. When initial surgical management has failed or when larger lesions are present, patients may be treated with an osteoarticular transfer system, mosaicplasty, bulk allograft, or autologous chondrocyte implantation6.

The treatment for osteochondral lesions of the talus has been guided by the results of surgical procedures performed for similar pathology within the knee; studies utilizing arthroscopic drilling and osteochondral transplantation have shown promising short-term results as primary treatment5,7-12. Nonetheless, little information is available regarding . . . [Full Text of this Article]


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