Osteochondral Lesions of the Talus


An osteochondral lesion of the talus is a defect in the cartilage of the talus resulting from injury to the cartilage surface, underlying bone, or both, and leading to ankle pain and dysfunction. Such lesions are a significant source of ankle pathology that can lead to long-term disability and arthritis. They can affect the young and old alike, and may be related to acute trauma or chronic instability, or may be congenital, but are often related to a combination of these factors. Because of the relatively small surface area of the talus, loss of even a small area of its cartilage is poorly tolerated, and surgery is often required for lesions that do not heal primarily. Surgical options for the treatment of symptomatic lesions have been a subject of controversy. The simplest such option is arthroscopic excision of a loose fragment of cartilage and bone. However, inconsistent results of the simple excision of such fragments have led to a variety of treatments that vary with the type of lesion that exists. These are aimed at the stabilization of cartilage in situ or restoration of the articular surface of the talus when a defect is present. This article reviews the diagnostic and treatment options for osteochondral lesions of the talus.

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