Osteochondral Lesions Management in Ankle Surgery
Summary
Osteochondral lesions of the ankle encompass damage to the articular cartilage and underlying subchondral bone, most commonly affecting the talar dome following trauma such as sprains or fractures. Left untreated, these defects can progress to persistent pain, impaired function and early osteoarthritis. Management strategies range from conservative measures—activity modification, bracing and physiotherapy—to a spectrum of surgical interventions. Minimally invasive arthroscopic techniques include debridement and microfracture to stimulate marrow-derived repair tissue, while more extensive lesions may require osteochondral grafting, autologous chondrocyte implantation or biomimetic scaffolds. Innovative approaches such as press-fit osteoperiosteal grafting harness autogenous bone and periosteum, avoiding donor-site morbidity and hardware. Radiological modalities—MRI, CT and specific scoring systems—are integral for lesion characterisation, surgical planning and post-operative assessment. Patient-centred factors, including lesion size, depth, cartilage integrity and activity level, guide the choice of modality. Emerging concepts emphasise standardised outcome measures, personalised treatment algorithms and the interplay between biological augmentation and mechanical restoration to achieve durable joint preservation and functional recovery.
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Osteochondral Lesions Management in Ankle Surgery publication trend
The graph below shows the total number of articles in osteochondral lesions management in ankle surgery across all publications each year (not limited to Nature Index journals).
Technical terms
Osteochondral lesion: damage to both the articular cartilage and underlying subchondral bone of the ankle joint.
Microfracture: arthroscopic marrow stimulation technique involving perforation of the subchondral plate to induce repair tissue formation.
Press-fit grafting: implantation of an osteochondral or osteoperiosteal graft secured by friction without additional hardware.
MOCART 2.0 ankle score: a magnetic resonance-based grading system assessing seven distinct features of cartilage repair tissue on a 0–100 scale.
Retrograde drilling: surgical drilling from the subchondral bone upward to decompress cystic lesions while maintaining a healthy cartilage surface.
References
- The MOCART (magnetic resonance observation of cartilage repair tissue) 2.0 Ankle Score. Insights into Imaging (2024).
- Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) for large medial talar osteochondral defects. Operative Orthopädie und Traumatologie (2020).
- Retrograde drilling for ankle joint osteochondral lesions: a systematic review. Journal of Orthopaedics and Traumatology (2023).
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