Regeneration: Bone-Marrow Stimulation of the Talus-Limits and Goals

Jeff S Kimball; Richard D Ferkel; Eric I Ferkel

doi:10.1016/j.fcl.2024.01.001

Regeneration: Bone-Marrow Stimulation of the Talus-Limits and Goals

Foot Ankle Clin. 2024 Jun;29(2):281-290. doi: 10.1016/j.fcl.2024.01.001. Epub 2024 Feb 10.

Authors

Jeff S Kimball¹, Richard D Ferkel¹, Eric I Ferkel²

Affiliations

¹ Department of Orthopaedic Surgery, Southern California Orthopedic Institute, Van Nuys, CA, USA.
² Department of Orthopaedic Surgery, Southern California Orthopedic Institute, Van Nuys, CA, USA. Electronic address: eferkel@scoi.com.

PMID: 38679439
DOI: 10.1016/j.fcl.2024.01.001

Abstract

Bone Marrow Stimulation of osteochondral lesions of the talus has been shown to be a successful way to treat cartilage injuries. Newer data suggest that Bone Marrow Stimulation is best reserved for osteochondral lesions of the talus Sizes Less Than 107.4 mm² in area. Additionally, newer smaller and deeper techniques to perform bone marrow stimulation have resulted in less subchondral bone damage, less cancellous compaction, and superior bone marrow access with multiple trabecular access channels. Biologic adjuvants such as platelet-rich plasma (PRP), hyaluronic acid (HA), and bone marrow aspirate concentrate (BMAC) may lead to better functional outcomes when used concomitant to bone marrow stimulation.

Keywords: Ankle arthroscopy; Bone marrow stimulation; Cartilage; Microfracture; Osteochondral lesion; Talus.

Publication types

Review

MeSH terms

Bone Marrow
Bone Regeneration / physiology
Cartilage, Articular / injuries
Cartilage, Articular / physiology
Cartilage, Articular / surgery
Humans
Platelet-Rich Plasma
Talus* / injuries
Talus* / surgery