Research progress on operative treatment of osteochondral lesions of the talus

Abstract

Objective To summarize operative treatment of osteochondral lesions of the talus. Methods A computer-based search was conducted in PubMed and Springer link for literatures related to operative treatment of osteochondral lesions of the talus from January 2010 to November 2014 with the key wordsosteochondral lesions,talusin English. Analysis was conducted based on the articles. Results Surgical options are lesion excision, excision and curettage, microfracturing, antegrade (transmalleolar) drilling, retrograde drilling, which are suitable for younger patients with small, superficial or isolated lesions, fixation and techniques such as osteochondral transplantation(autograft or allograft) and autologous chondrocyte implantation. Osteochondral transplantation is often applied if the damages are large or osteochondral lesions. The arthroscopic technique with the superiority of minimally invasive, orthophoria operation may represent a precious aid for the orthopedic surgeon and for the patient's outcome. Diagnosis and treatment can be conducted simultaneously with arthroscopic technique. It is the first choice of the operative treatment of osteochondral lesions of the talus. In children, the lesions are rare. Fixation and debridement and bone marrow stimulation of an osteochondral talar defect are both good surgical options after failed conservative treatment. Conclusions In most cases, several treatment options are viable, which have their indications and the advantages and disadvantages. The principle ofindividualizationshould be emphasized and the choice of treatment is based on defect type and size, age of patients and preferences of the treating clinician. It is the key to surgical treatment. Key words: Bone diseases; Osteochondral lesions; Talus; Treatment