osteochondral allograft

Options

Microfracture

MACI

AMIC

Mosaicplasty / Osteochondral autograft

Osteochondral allografts

Treatment Algorithms

Indications

- grade 3 or 4 ICRS lesions

Niemeyer et al Arthroscopy 2011

- lesions < 4cm2 microfracture

- lesions > 4cm2 or failed microfracture ACI

Cole et al JBJS 2009

Epidemiology

Rare 

- 2% of acute dislocations

Often missed

- < 1/ 52 25%

- < 6/52 25%

- < 6/12 25%

- > 6/12 25%

Aetiology

Definition

Fracture talus through articular cartilage into subchondral bone

- 2° force transmitted from distal tibia

Osteochondritis dissecans v osteochondral fracture

Epidemiology

6% ankle sprains

Average age = 25 

M > F

Location