Diagnosis and Treatment of Persistent Problems After Ankle Sprains: Surgical Management of Osteochondral Lesions of the Talus

Ankle sprains are common injuries that can lead to persistent disability and pain for many patients. Such symptoms are often a result of damage to the articular cartilage of the talar dome and the subchondral bone, an injury broadly classified as an osteochondral lesion of the talus. Lesions indicated for surgery can be treated with a range of methods. These generally fall into the categories of reparative treatment, which is suitable for smaller lesions and can typically be performed arthroscopically, or replacement strategies, which can provide superior outcomes for large lesions but often require an open approach. In recent years, many treatment options have incorporated stem cells and other biologics that seek to improve healing. We will provide an overview of indications for the treatment of talar osteochondral lesions and current treatment strategies before discussing our favored technique, outcomes, and potential complications.