Autologous Costal Osteochondral Transplantation for Talar Osteochondral Lesions

"Operating steps:~1. Arthroscopic examination of the size and location of the talar osteochondral lesion;~2. Make a transverse incision (approximately 4 cm long) at the osteochondral junction of the fifth or sixth rib, and harvest an osteochondral column from the rib;~3. Thoroughly remove the talar osteochonral lesion through arthrotomy or Chevron osteotomy of the medial malleolus;~4. Trim the autograft according to the size of the lesion;~5. Fill the peri-lesion cavity with cancellous bone, and finally embed the costal osteochondral autograft into the talar defect, ensuring that the cartilage surface of the transplant to be flush with the normal talar cartilage around it;~6. Suture the joint capsule or reduct and fix the medial malleolus, and close the incision layer by layer."

"Operating steps:~1. Arthroscopic examination of the size and location of the talar osteochondral lesion;~2. Make an incision along the anterior iliac crest. At the time of exposure, pay attention not to damage the periosteum. Obtain a cylindrical osteoperiosteal column by an appropriate-sized harvester tube.~3. Thoroughly remove the talar osteochonral lesion through arthrotomy or Chevron osteotomy of the medial malleolus;~4. Fill the peri-lesion cavity with cancellous bone, and finally embed the iliac osteoperiosteal autograft into the talar defect, ensuring that the periosteum surface of the transplant to be flush with the normal talar cartilage around it;~5. Suture the joint capsule or reduct and fix the medial malleolus, and close the incision layer by layer."