2023 Annual Meeting Foot & Ankle Access Pass-Opinion: Less Is More! Marrow Stimulation and Other Surface Treatments for Osteochondral Lesions of the Talus

Opinion: Less Is More! Marrow Stimulation and Other Surface Treatments for Osteochondral Lesions of the Talus

Video Transcription

Video Summary

Dr. Nick Van Dyke, a pioneer in arthroscopy, discussed treatment of ankle cartilage defects. He emphasized that pain originates from bone, so bone marrow stimulation (microfracture) has been the mainstay for 25 years. Recent systematic reviews show no single superior intervention, with bone marrow stimulation succeeding in about 82% cases and favored by 80% of surgeons worldwide. Long-term studies confirm lasting outcomes with minimal joint narrowing. Larger lesions and osteochondral autograft transplantation (OAT) pose higher donor site morbidity, especially in low-volume centers. Emerging custom metal implants show promise for the future. Overall, bone marrow stimulation remains a simple, effective, and durable first-line treatment.

Asset Caption

C. Niek Van Dijk, M.D.

Keywords

ankle cartilage defects

bone marrow stimulation

microfracture

osteochondral autograft transplantation

custom metal implants