Osteochondral lesions of the talus: Diagnosis and treatment
Treatment of symptomatic focal talar osteochondral defects has undergone a dramatic evolution over the past decade. Although the standard of operative care remains debridement and drilling of talar dome lesions, the concern remains that replacing larger defects with fibrocartilage and not hyaline cartilage may not be a sensible long-term solution. While cartilage resurfacing procedures, including osteochondral autograft/allograft transfer, mosaicplasty, autologous chondrocyte transplantation currently are viewed as salvage procedures, perhaps consideration should be given to applying these techniques as primary surgical treatment of larger talar osteochondral defects. This review article addresses the current concepts in the management of osteochondral lesions of the talus, including: (1) diagnosis and staging, (2) nonoperative management, and (3) operative intervention. Even though debridement and drilling of osteochondral lesions will be included, the section on surgical management emphasizes recent reported results and advances in cartilage resurfacing. © 2003 Lippicott Williams & Wilkins.
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