SA Orthopaedic Journal
On-line version ISSN 2309-8309
An osteochondral defect of the talus is a lesion involving talar articular cartilage and subchondral bone. It is frequently caused by a traumatic event. The lesions may either heal, stabilise or progress to subchondral bone cysts. The subchondral cysts may develop due to the forcing of cartilaginous or synovial fluid with every step. Malalignment of the hindfoot plays an important role in the development of further degeneration. Plain radiographs may disclose the lesion. Modern imaging technology has enhanced the ability to fully evaluate and accurately determine the size and extent of the lesion, which are fundamental for proper treatment. Asymptomatic or low-symptomatic lesions are treated nonoperatively. For surgical treatment the following types of surgery are in clinical use: debridement and bone marrow stimulation, retrograde drilling, internal fixation, cancellous bone grafting, osteochondral autograft transfer, autologous chondrocyte implantation, and allograft transplantation. Although these are often successful, malalignment may persist with these treatment options. Calcaneal correction osteotomy may be suitable for osteochondral defects in select cases.