Particulated Juvenile Cartilage Allograft Transplantation for the Treatment of Osteochondral Lesions of the Talus

Osteochondral lesions of the talus present a formidable treatment challenge to the orthopaedic surgeon. Although debridement with either microfracture, drilling, or curettage is often successful in relieving pain and growing fibrocartilage within a standard lesion, the option of implanting particulated juvenile cartilage allograft has become a promising treatment alternative for patients who have failed routine treatment or who have osteochondral lesions that are known to do poorly from the onset. Particulated juvenile cartilage allograft transplantation delivers 1 mm3 of fresh juvenile cartilage, which contain live cells in their native extracellular matrix, that are secured into the osteochondral defect with the use of a fibrin adhesive. The current evidence, indications, and surgical technique for the use of particulated juvenile cartilage allograft transplantation in the management of osteochondral lesions of the talus have been reviewed.