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J Am Acad Orthop Surg, Vol 17, No 7, July 2009, 407-414.
© 2009 the American Academy of Orthopaedic Surgeons
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Cartilage Transplantation Techniques for Talar Cartilage Lesions

Matthew E. Mitchell, MD, Eric Giza, MD and Martin R. Sullivan, MD

Perspectives on Modern Orthopaedics articles provide an objective appraisal of new or controversial techniques or areas of investigation in orthopaedic surgery.

Dr. Mitchell is Orthopedic Surgeon, Casper Orthopedic Associates, Casper, WY. Dr. Giza is Assistant Professor of Orthopaedic Surgery and Chief, Foot & Ankle Surgery, UC Davis Department of Orthopaedic Surgery, Sacramento, CA. Dr. Sullivan is Foot and Ankle Fellowship Director, St. Vincent’s Clinic, Sydney, NSW, Australia.

Dr. Mitchell or a member of his immediate family serves as a board member, owner, officer, or committee member of the American Orthopaedic Foot and Ankle Society and CPT Committee. Dr. Giza or a member of his immediate family serves as a paid consultant to or is an employee of Arthrex. Neither Dr. Sullivan nor a member of his immediate family has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article.

Reprint requests: Dr. Sullivan, Suite 901 East, 438 Victoria Street, Darlinghurst, St. Vincent’s Clinic, Sydney, NSW 2010 Australia.

Talar articular cartilage is known to differ significantly from knee cartilage. Even so, recommendations for the treatment of talar cartilage lesions have been based on strategies for the knee. Arthroscopic management of osteochondral lesions of the talus is well documented. Results have been favorable with reparative techniques such as débridement with curettage and débridement with drilling, whether undertaken via early open techniques or more recent arthroscopic procedures. Salvage of failed reparative techniques is controversial. Early efforts to salvage failed débridement focused on osteochondral allografts and autografts that used the knee as a donor site. Results of these restorative techniques have been favorable, but concerns have been raised regarding knee donor site morbidity, the use of malleolar osteotomy, and incomplete restoration of the talar articular surface. More recent restorative techniques developed for the knee have been adapted for the ankle, such as autologous chondrocyte implantation and matrix-induced autologous chondrocyte implantation.






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Copyright © 2009 by the American Academy of Orthopaedic Surgeons.