There are various published surgical techniques for treatment of symptomatic osteochondral lesions. Generally these are based on one of the following three principles:

1. Debridement and bone marrow stimulation (microfracture, abrasion arthroplasty, drilling).
2. Securing a lesion to the talar dome (retrograde drilling, fragment fixation).
3. Stimulating the development of hyaline cartilage (osteochondral autografts, allografts, autologous chondrocyte implantation).

The choice of the treatment for osteochondral lesions depends on the symptoms, the duration of complaints, the size of the defect and whether it concerns a primary or secondary osteochondral defect.

In this Picture of the Week we present a patient with deep ankle pain due to an osteochondral defect of the talus, smaller than 15 mm as measured on a pre-operative CT-scan. Therefore this patient is treated by means of artrhoscopic debridement and microfracturing.

For the complete Debridement and Microfracturing technique: CLICK HERE.