Related Experiment Video
Updated: Jan 22, 2026
Autologous Microfractured and Purified Adipose Tissue for Arthroscopic Management of Osteochondral Lesions of the Talus
Published on: January 23, 2018
Structural Allograft Transplantation for Osteochondral Lesions of the Talus
Samuel B Adams1, Nicholas A Viens1, Mark E Easley1
1Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC 27710. E-mail address for S.B. Adams, Jr.: samuel.adams@duke.edu. E-mail address for N.A. Viens: Nicholas.viens@duke.edu. E-mail address for M.E. Easley: easle004@mc.duke.edu. E-mail address for J.A. Nunley II: nunle001@mc.duke.edu.
Introduction:
We describe the technique for structural allograft transplantation to treat large talar shoulder lesions.
Step 1 Patient Selection And Education:
The patient and surgeon must be prepared for a waiting time of unknown length and have a flexible schedule for when the graft is ready for implantation.
Step 2 Preoperative Planning And Approval:
Inspect the graft for the correct approximate size, operative side, and quality of the cartilage surface prior to proceeding with surgery.
Step 3 Surgical Approach And Osteotomy:
Make sure that the proposed osteotomy site exits into the tibial plafond and not at the axilla as this allows for easier access to the lesion.
Step 4 Prepare Recipient Site:
Measure the dimensions of the talar defect and its location from anterior to posterior along the talar shoulder at least twice.
Step 5 Harvest Graft From Donor Talus:
Err on the side of creating too large a graft that later can be trimmed instead of a graft that is initially too small.
Step 6 Implant And Secure Graft Into Recipient Site:
Secure the graft with one or two 1.5 or 2.0-mm-diameter solid screws.
Step 7 Reduce Osteotomy Site And Close:
Ensure that there is no intra-articular step-off.
Step 8 Postoperative Care:
After transitioning to a boot-brace, the patient should remove it to perform ankle range-of-motion exercises four to five times per day.
Results:
In our series, there were eight patients with a mean age of thirty-one years (range, seventeen to forty-four years).
What To Watch For:
IndicationsContraindicationsPitfalls & Challenges.
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