Abstract
Cartilage injuries of the talus can be challenging to treat. In the USA, 250,000–300,000 patients with symptomatic cartilage injuries undergo surgical treatment, most commonly in the knee. Though the majority of ankle osteochondral lesions can be managed with debridement, microfracture, and/or drilling with good results, many, especially those >150 mm2, have poorer outcomes [1–3]. In fact, that number may be even smaller as Ramponi et al., reported in their recent systematic review. They found that lesions of 107.4 mm2 might be the maximum size for drilling or microfracture for good outcomes [4]. For larger lesions, there are other treatment options available. These include osteochondral allografts, osteochondral autografts (single plug or mosaicplasty), autologous chondrocyte implantation (ACI), juvenile allografts, micronized cartilage matrix, and resurfacing procedures (Fig. 10.1). Factors influencing choice of surgical procedure include: size of lesion, location of lesion, containment, associated subchondral cyst, status of cartilage cap, associated pathology, and patient preference.
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Haloman, S., Ferkel, R. (2020). The Use of Aci/Maci to Restore Osteochondral Defects in the Ankle. In: Allegra, F., Cortese, F., Lijoi, F. (eds) Ankle Joint Arthroscopy. Springer, Cham. https://doi.org/10.1007/978-3-030-29231-7_10
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