Particulate Juvenile Articular Cartilage Transfer for Talar Osteochondral Lesions

Abstract

Osteochondral lesions of the talus present a challenge to the foot and ankle surgeon with regards to treatment. Although most bone marrow stimulation (BMS) procedures have relatively good outcomes, those patients who do not improve or present with large lesions (>1.5 cm2) are candidates for a range of more involved procedures. All of these treatments focus on improving pain and function by restoring cartilage at the lesion site. Treatment options are generally classified as either BMS or restorative. Histologic studies have found that BMS leads to infill by fibrocartilage that has physical properties inferior to that of native hyaline cartilage. The goal of restorative treatments is to create hyaline or hyaline-like cartilage. This category includes a variety of techniques each with their own advantages and disadvantages. This paper focuses specifically on one of these techniques, particulate juvenile articular cartilage transfer. A brief overview of BMS and restorative treatment options is provided. A detailed description of the surgical technique for particulate juvenile articular cartilage transfer and a review of published clinical results are discussed. Level of Evidence: Level V—expert opinion. See Instructions for Authors for a complete description of levels of evidence.