Arthroscopic Treatment of Osteochondral Talar Defects

Arthroscopic debridement and bone marrow stimulation (i.e., drilling or microfracturing) is considered the primary surgical treatment of osteochondral defects of the talus.

For anterior ankle arthroscopy, position the patient supine; for posterior arthroscopy, position the patient prone.

For anterior ankle arthroscopy, place the portals medial to the tibialis anterior tendon and lateral to the peroneus tertius tendon at the level of the ankle joint; for posterior arthroscopy, place the portals lateral and medial to the Achilles tendon just above the level of the tip of the lateral malleolus.

Fully debride the osteochondral defect and create multiple microfractures in the bottom of the defect.

Prescribe partial weight-bearing for six weeks.

A systematic review of the literature identified eighteen studies on bone marrow stimulation that included a total of 388 patients³. The study weighted success rate was 85% (range, 46% to 100%).

IndicationsContraindicationsPitfalls & Challenges.