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Updated: Jun 27, 2026
Autologous Microfractured and Purified Adipose Tissue for Arthroscopic Management of Osteochondral Lesions of the Talus
Published on: January 23, 2018
Modified step-cut medial malleolar osteotomy for osteochondral grafting of the talus
Keun-Bae Lee1, Hyun-Kee Yang, Eun-Sun Moon
1Department of Orthopedic Surgery, Chonnam National University Medical School & Hospital, 8 Hakdong, Donggu, Gwangju, 501-757, Korea. kbleeos@chonnam.ac.kr
Background:
Osteochondral grafting for the treatment of osteochondral lesions of the talus (OLT) usually requires a medial malleolar osteotomy (MMO) to achieve adequate intraarticular exposure. This study describes the technique used and the results obtained using a modified step-cut MMO for osteochondral grafting of talar dome lesions.
Materials And Method:
Eleven feet in ten patients underwent modified step-cut MMO prior to osteochondral grafting for OLT. The patients included three women and seven men with a mean age of 40 (range, 20 to 51) years. Modified step-cut MMO consisted of an oblique osteotomy, which was made at approximately 45 degrees to the transverse plane of the proposed traditional step-cut osteotomy, and a vertical osteotomy to the axilla on the medial tibial plafond.
Results:
In all patients, modified step-cut MMO provided better perpendicular access to lesions than traditional step-cut osteotomy. In all cases, the osteochondral graft plug was accurately set perpendicular to the defect area, and all ten patients experienced uncomplicated osteotomy healing at a mean 8 weeks postoperatively without loss of reduction or malreduction.
Conclusion:
Modified step-cut MMO is an excellent, reproducible method for perpendicular access to a talar dome lesion.
