Osteochondral lesions of the talus are a common cause of ankle pain and disability. After failure of nonsurgical management, surgical options tailored to specific characteristics of the lesion are considered. Surgical interventions include marrow-stimulation techniques, such as debridement and microfracture, osteochondral autograft transfer, osteochondral allograft transfer, autologous chondrocyte implantation, and particulated juvenile cartilage allograft transplantation. Cartilage mesh allograft, a viable whole-tissue cartilage allograft, is a new product designed to augment marrow-stimulation procedures. This article will provide an overview of current management options available for the treatment of osteochondral lesions of the talus and focus on the emerging use of cartilage mesh allograft to enhance traditional surgical techniques.
Level of Evidence: Diagnostic Level 4. See Instructions for Authors for a complete description of levels of evidence.