The Use of Allograft for Osteochondral Lesions of the Talus

Osteochondral lesions of the talus is a common problem affecting the ankle, particularly in you active patients. Patients recalcitrant to conservative modalities may require surgical correction. While many lesions may respond to arthroscopic management, larger or recurrent lesions may require osteochondral transplantation for which autograft of allograft tissue can be used. This chapter reviews the basic science and biology of fresh talar allograft ostechondral transplnattaion. Two techniques are described in detail. The first utilized osteochondral plugs using a system similar to that used for autograft OATS procedures. The second utilized larger bulk allograft pieces inserted following a talar dome hemitalectomy for more massive lesions. The surgical techniques, indications, concerns and results are described in the chapter.