Osteochondral allograft transplantation in the ankle: A review of current practice

Abstract

Osteochondral allograft transplantation is a technique that was first developed to treat cartilage pathology in the knee. Over the past 15 years, this technology has been translated to the treatment of osteochondral lesions and end-stage arthritis of the ankle. For osteochondral lesions of the talus or the tibia, a fresh osteochondral allograft transplant can be fashioned to match a specific defect and is useful for large, cystic or uncontained lesions. For a young patient with end-stage arthritis, bipolar fresh osteochondral allograft transplantation is a treatment alternative to ankle arthrodesis. Evidence for these operations is limited and consists primarily of case series, which have reported variable rates of success and in some cases high rates of complications and reoperations. Nevertheless, these techniques continue to evolve and should be considered as options for patients with certain conditions that are particularly challenging to treat.