Autogenous osteochondral mosaicplasty for the treatment of the talus

Mosaicplasty is a usual treatment in chondral defects of talus, givinga hyaline cartilage replacement. The aim of our study is a retrospectiveevaluation on 36 patients with a chondral or subchondraldefect of talus, operated on between June 1997 and September2001, using mosaicplasty with malleolar process osteotomy. Graftswere harvested on trochlea of homolateral knee. Results are reportedon file established by the International Cartilage RepairSociety. Cartilage lesions were deep (grade III or IV), 33 on 36cases have needed a malleolar osteotomy. Results were excellent orgood in 81% of the cases (grade ICRS I or II) with an 18 monthfollow-up, there was no case of aggravation. This technique shouldbe reserved for young, active and symptomatic patients. Althoughmore difficult and aggressive than the traditional technique (Pridie,debridement, microfracturing), mosaicplasty can get a hyaline healing.Lateral or medial osteotomies are necessary to have a perfectview on posterior part of talus where cartilage defects are inaccessible.Morbidity on donor site was low and acceptable. A longerfollow up will be necessary to evaluate stability of clinical andradiological results, morbidity of donor site and a possible preventiveaction on osteoarthritis.