Bilateral osteochondral lesion

Osteochondral Defects

Description of patient (type of occupation, indication of age, intensity of sport):

29 year old non athlete females

History and previous treatment:

8 months of pain in right ankle. No history of known trauma. Steroid injection with temporary relief. Arthoscopic debridement and microfractures right ankle 5 months ago

Current complaints:

Still in pain, edema and limitation in activities of daily living

Physical examination:

Limited ROM. Normal lower extremity alingnment. Ankle edema right foot. Subtalar, Chopart and forefoot normal



Additional investigation (CT/MRI)
[Picture 1, 2 + 3]


Case summary:

29 year old female. Arthroscopic debridement and microfractures right talus five moths ago. Ongoing symptoms with pain, limitation on daily living activities

Question(s) to this case:

Next treatment options: OATS procedure or repaet debridement and microfracture??? In Colombia fresh frozen osteochondral graft is not an option.


Make a standing AP X-Ray and look at the alignment. Not only radiological alignment but also clinical alignment.
Consider a lateralising calcaneal osteotomy!
Of course OATS is an option. A second debridement has a 70 % chance. An OATS 85-90%