All-Arthroscopic Treatment of Dependent Osteochondral Lesions of the Ankle: Surgical Technique

A large number of articular cartilage defect treatments have been described. However, few have discussed the use of biologic agents implanted into the so-called dependent defect arthroscopically. Furthermore, even fewer of these reports have contained a description for treating dependent osteochondral lesions of the tibial plafond. Generally, these lesions have been treated with either microfracture or debridement, and the long-term outcomes have been less than satisfactory. With new interest in biologic treatments for osteochondral defects, we believe that bone marrow aspirate concentrate combined with a biologic scaffold provides the necessary components to provide healing of these so-called dependent lesions. We believe that the combination of bone marrow aspirate concentrate and a biologic scaffold create the perfect viscosity to hold their mold in these dependent osteochondral lesions and provide the perfect scaffold to enhance recovery. We believe that our technique provides a minimally invasive option for the treatment of these osteochondral lesions and eliminates the need for a large arthrotomy.