Osteochondral lesions of the talar head – A case report, review of the literature, and novel surgical technique utilizing nano-arthroscopy and biologics

Abstract

A 15 year-old competitive football player was found to have an osteochondral defect of the talar head without an inciting injury. Osteochondral lesions of the talar head are extremely rare with only ten other reported cases in the literature.1-9 This patient failed conservative management and was indicated for a surgical intervention. He underwent nano-arthroscopy of the talonavicular joint with debridement of the lesion, retrograde percutaneous drilling and curettage of the defect, application of demineralized bone graft with concentrated bone marrow aspirate to the bony defect, and injection of concentrated bone marrow aspirate in the joint for any chondral damage. This was the first reported case to describe nano-arthroscopy in the talonavicular joint and to utilize the combination of demineralized bone graft with concentrated bone marrow aspirate in the treatment of osteochondral defects.

Keywords

• OCD
• Talar head
• Osteochondral lesion
• Osteochondral defect
• Osteochondritis dissecans
• Osteochondral fracture