An anterior ankle arthroscopic technique for retrograde osteochondral autograft transplantation of posteromedial and central talar dome cartilage defects

Abstract

This cadaveric study showed that the retrograde osteochondral autograft transplantation technique in the talus is feasible. It can be used to restore the posteromedial and central talar articular surfaces using conventional ankle arthroscopic instrumentation and anterior arthroscopic portals without resorting to a medial malleolar osteotomy. Further clinical and biomechanical studies are required to prove the efficacy of this technique and its reproducibility in routine clinical practice.

Therapeutic Efficacy Analysis of Talar Fracture Internal Fixation with Lateral Malleolar Osteotomy

“…There are 3 kinds of traditional surgical approaches: the anterior medial, anterolateral, and posterolateral approaches [3]. For talar fractures, a double incision is usually performed, including medial and lateral incisions [4]. The medial incision originates from the tip of the medial malleolus and extends to the scaphoid between the anterior and posterior tibial tendons, and the lateral incision starts from the lateral malleolus tip and extends to the middle of the wedge or base of the fourth metatarsal.…”

Anterior Ankle Arthroscopy

“…41 Arthroscopically assisted treatment of talar dome cartilage defects has been described. [42][43][44] The appropriateness of arthroscopy in reaching talar osteochondral lesions can be estimated based on geographic location of the lesion on computed tomography. The anterior defect border is the landmark for accessibility because only this part of the defect has to be identified initially during arthroscopy.…”

Medial malleolar osteotomy for the treatment of talar osteochondral lesions: anatomical and morbidity considerations

“…While on the anterolateral talar edge many surgical techniques (including microfracture, chondrocyte implantation, or mosaicplasty) can be performed arthroscopically or using mini‐open techniques, only few arthroscopy specialists in the field can perform these techniques on the posteromedial talar edge [34]. If arthroscopic or mini‐open access to the lesion on the medial side is not sufficient, better access can be achieved by adding an osteotomy [2, 20, 33]. Different osteotomy techniques have been described: osteotomy of the medial malleolus can be performed with one oblique cut [17, 22, 31, 32], a chevron‐type cut [12, 20], or a step cut [14, 28, 29].…”