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Background <p>Therapeutic options for osteochondral lesions of the talus (OLT) are diverse and depend primarily on lesion location and thus arthroscopic accessibility as well as lesion size and depth.</p> Diagnostics <p>Magnetic resonance imaging (MRI) is the modality of choice for assessing cartilage damage with subchondral involvement, associated bone marrow edema and concomitant pathologies of ligaments or tendons. Weight-bearing radiographs provide complementary information regarding hindfoot alignment, while cone-beam computed tomography (CBCT) enables a&#xa0;more precise evaluation of osseous involvement.</p> Treatment <p>Lesions up to 1 cm<sup>2</sup> are primarily treated using bone marrow stimulation techniques (drilling or microfracture). For larger lesions or revision procedures, bone marrow stimulation alone is insufficient and additional coverage to the joint surface, such as scaffold or membrane-based techniques, should be considered. Depending on lesion depth, supplementary cancellous bone grafting may be required.</p> Conclusion <p>Osteochondral lesions of the talus can be effectively addressed arthroscopically. The limitations are mainly related to anatomical accessibility and lesion depth. Clinical outcomes are comparable to those achieved with open surgical techniques; however, persistent symptoms and recurrence can occur.</p>

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Arthroskopische Knorpeltherapie am oberen Sprunggelenk

  • 期刊论文

  • 发表日期：

    2026年4月27日

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  • O. Gottschalk,
  • M. Walther

摘要

Background

Therapeutic options for osteochondral lesions of the talus (OLT) are diverse and depend primarily on lesion location and thus arthroscopic accessibility as well as lesion size and depth.

Diagnostics

Magnetic resonance imaging (MRI) is the modality of choice for assessing cartilage damage with subchondral involvement, associated bone marrow edema and concomitant pathologies of ligaments or tendons. Weight-bearing radiographs provide complementary information regarding hindfoot alignment, while cone-beam computed tomography (CBCT) enables a more precise evaluation of osseous involvement.

Treatment

Lesions up to 1 cm2 are primarily treated using bone marrow stimulation techniques (drilling or microfracture). For larger lesions or revision procedures, bone marrow stimulation alone is insufficient and additional coverage to the joint surface, such as scaffold or membrane-based techniques, should be considered. Depending on lesion depth, supplementary cancellous bone grafting may be required.

Conclusion

Osteochondral lesions of the talus can be effectively addressed arthroscopically. The limitations are mainly related to anatomical accessibility and lesion depth. Clinical outcomes are comparable to those achieved with open surgical techniques; however, persistent symptoms and recurrence can occur.