Surgical treatment of osteochondral defects (OCD) of the talus encompasses a wide variety of procedures. The results of autologous osteochondral grafting have been successful for articular cartilage defects of the talus; however, the risk of donor site morbidity from the ipsilateral knee cannot be overlooked. The use of fresh osteochondral allograft for cartilage defects in the talus represents an attractive alternative, particularly for large lesions not amenable to autologous grafting.

This topic presents the preoperative assessment and preoperative planning for surgical treatment of osteochondral defects of the talus that replaces osteochondral lesions of the talus with fresh allograft tissue. Included are discussions of the Hemitalus technique for large osteochondral defects, and techniques for lateral osteochondral defects and medial osteochondral defects.