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J Am Acad Orthop Surg, Vol 13, No 3, May/June 2005, 152-158.
© 2005 the American Academy of Orthopaedic Surgeons
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Osteochondral Lesions of the Talus

Aaron K. Schachter, MD, Andrew L. Chen, MD, MS, Ponnavolu D. Reddy, MD and Nirmal C. Tejwani, MD

Dr. Schachter is Resident, Department of Orthopaedic Surgery, NYU–Hospital for Joint Diseases, New York, NY. Dr. Chen is in private practice, Littleton, NH. Dr. Reddy is Fellow, Department of Orthopaedic Surgery, NYU–Hospital for Joint Diseases. Dr. Tejwani is Associate Professor, Department of Orthopaedic Surgery, NYU–Hospital for Joint Diseases.

Reprint requests: Dr. Tejwani, Bellevue Hospital–NB, 21 W 37, 550 First Avenue, New York, NY 10016.

Osteochondral lesions of the talus occur infrequently and usually represent late sequelae of ankle trauma. Because of the functional significance of the talus and its limited capacity for repair, correct early diagnosis is important. Osteochondral fractures should be suspected in patients with chronic ankle pain, especially those with a prior ankle injury. Historically, plain radiographs have been used to stage lesions; more recently, magnetic resonance imaging and arthroscopy have been used. Non-surgical management remains the mainstay of treatment of acute, nondisplaced osteochondral lesions. Surgical management is reserved for unstable fragments or failure of nonsurgical treatment. Recent advances in osteochondral grafting have allowed reconstruction of the talar dome, leading to more predictable relief of pain and improvement of function.






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