The role of arthroscopic debridement in the treatment of osteochondral lesions of the talus in the athlete

Abstract

<h2>ABSTRACT</h2> Arthroscopic debridement (AD) is the most common procedure in treating cartilage lesions. However, despite its comprehensive implementation in the surgical treatment of osteochondral lesions of the talar dome (OLT) during the last century, its practice was abandoned, preferring newer techniques, and is currently omitted in most treatment algorithms. Up to date, no conclusive evidence exists regarding the superiority of bone marrow stimulation over AD, and evidence continues to be scarce on its implementation. AD represents an easy, inexpensive, technically low-demanding procedure, with potential benefits due to its rapid rehabilitation, the lack of donor-site morbidity, and without compromising the subchondral (SC) plate and bone. The SC plate and bone have been acknowledged as essential structures for cartilage health and quality of the surgical repair, participating in the load transmission of the ankle joint and linking biochemically through transport pathways with the overlying hyaline cartilage. AD alone is an OLT treatment option with potential benefits for the athlete, especially in partial-thickness cartilage injuries and non-cystic contained International Cartilage Repair Society grade III-IV OLT less than 10 mm² in size and 5 mm in depth. Additionally, AD alone can represent an appealing option for athletes looking for symptomatic relief and a fast return to sports during the season.