Arthroscopic Revision Repair of Osteochondral Lesion of Talus Using Microfracture Drill and Bioengineered Dehydrated, Micronized Allogenic Cartilage Extracellular Matrix

Osteochondral lesions (OCD) of the talus are a common cause of chronic ankle pain and dysfunction, especially with history of injury and trauma to the ankle [1-3]. Lesions that do not respond to non-operative treatment may require surgical intervention arthroscopically or as an open procedure. Revision repair of osteochondral lesions historically has been performed as an open procedure with increased potential of postoperative complications. Smaller lesions that do not respond to non-surgical treatment have historically been treated with marrow stimulation, including micro fracture and subchondral drilling, yielding good results in the short-term [1-3]. Large lesions and revision cases, however, have been treated with more invasive procedures including osteochondral autograft transfer (OATS), and autologous chondrocyte implantation (ACI) [1-3]. These more invasive procedures have an increased risk of postoperative complications leading to additional morbidity affecting patient outcome [1-3]. The development of bioengineered dehydrated, micronized allogenic cartilage extracellular matrix may provide a minimally invasive way of treating the problematic large and revision-type lesions. In addition, this biomaterial in conjunction with platelet rich plasma may regenerate more hyaline-like cartilage when compared to micro fracture alone [2-5]. This case report presents a 26 year old female with an all-arthroscopic revision repair of an osteochondral lesion of the talus using a specific microfracture drill and a bioengineered dehydrated, micronized allogenic cartilage extracellular matrix.