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

J Foot Ankle Surg. May-Jun 2017;56(3):613-617. doi: 10.1053/j.jfas.2017.01.047.

Abstract

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.

Keywords: articular cartilage; bone marrow aspirate concentrate; osteochondral lesion; tibial plafond.

MeSH terms

  • Ankle Joint / surgery*
  • Arthroscopy*
  • Biocompatible Materials / therapeutic use*
  • Bone Marrow Transplantation*
  • Cartilage, Articular / injuries
  • Cartilage, Articular / surgery*
  • Guided Tissue Regeneration*
  • Humans
  • Tibia / injuries
  • Tibia / surgery
  • Transplantation, Autologous

Substances

  • Biocompatible Materials