Arthroscopic debridement of osteochondral lesions of the talus

Abstract

Osteochondral ankle defects are mostly caused by a traumatic event but can occur even spontaneously. Conservative treatment is the first choice of management, but in case of persistence of symptoms, surgical treatment is required.Over the last decades, several techniques have been developed, but currently no clear guidelines exist yet, and the best choice of surgical treatment is still debated.This chapter focuses on a particular set of procedures, such as arthroscopic debridement, microfracturing and/or microdrilling. The main goals are cleaning the ankle joint from every osteochondral fragment and modelling and promoting the development of a new articular surface over the defect area in order to restore the previous functional qualities. All these results must be reached as less invasively as possible, avoiding risks of thermal damage during the procedure, limiting postoperative complications and permitting a reasonable fast recovery.In the presence of specific indications, such as a small- to medium-sized lesion, primary surgery, young patients, a traumatic etiology and lateral lesions, excellent results can be reached with an effective, minimally invasive and not expensive strategy.