AANA19 Foot & Ankle Access Pass-Clinical Cases_ Foot and Ankle-Dr. James W. Stone, M.D.

Clinical Cases_ Foot and Ankle-Dr. James W. Stone, M.D.

Video Transcription

Video Summary

A man in his early 30s suffers chronic medial ankle pain from a medial talar dome lesion. Initial arthroscopic debridement and microfracture failed. Subsequent surgery included a medial malleolar osteotomy and absorbable tacks, but symptoms persisted with malunion and lesion presence. Experts discuss treatment complexities: lesion size, containment, and biological augmentation such as cartilage transplants, juvenile cartilage, micronized cartilage with bone marrow aspirate concentrate, or osteochondral allografts. Repeat arthroscopy with biologics is favored over repeat microfracture. The patient eventually received an osteochondral allograft after a redo osteotomy, showing promising two-year outcomes despite earlier failed procedures.

Keywords

medial talar dome lesion

chronic ankle pain

osteochondral allograft

medial malleolar osteotomy

biological augmentation