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Updated: May 22, 2026
Autologous Microfractured and Purified Adipose Tissue for Arthroscopic Management of Osteochondral Lesions of the Talus
Published on: January 23, 2018
Treatment of post-traumatic osteochondral lesions of the talus: a four-step approach
Alberto Ventura1, Clara Terzaghi, Claudio Legnani
1U.O.S.D. Chirurgia Articolare Mininvasiva (Minimally Invasive Articular Surgery Unit), Istituto Ortopedico G. Pini, Milan, Italy. alberto.ventura@doctoral.it
Purpose:
The purpose of this retrospective study was to assess the treatment of post-traumatic osteochondral lesions (OCLs) of the ankle with a four-step protocol.
Methods:
Thirty-eight patients with at least one MRI-documented OCL of the ankle were treated from 2004 to 2010. Median age at surgery was 39 years (range: 18-52). Mean lesion size was 1.0 cm(2) (SD: 0.2). All patients underwent a four-step surgical procedure including synovectomy, debridement and microfractures of the OCL, capsular shrinkage, and bracing and non-weightbearing for 21 days. Clinical assessment included objective examination, the AOFAS ankle and hindfoot scoring system, Karlsson-Peterson score, Tegner activity level, and Sefton articular stability scale. MRI scans were taken 18 months after surgery in all patients.
Results:
Follow-up examination at an average of 4 years (SD: 1.1) after surgery showed significant improvement of all variables compared to pre-operative values (P < 0.05). Most patients rated their outcome as good/excellent. MRI scans taken 18 months after surgery documented completely repaired lesion in 27 ankles, slight bone marrow oedema with partially repaired defect in 9 patients, and visible defect in 2 ankles.
Conclusion:
Based on the present results, we propose a comprehensive four-step protocol as a safe and clinically effective treatment option in patients with post-traumatic OCLs of the ankle.
