Commentary| Volume 56, ISSUE 5, P937, September 2017

Functional Medium-Term Results After Autologous Matrix-Induced Chondrogenesis for Osteochondral Lesions of the Talus: A Five-Year Prospective Cohort Study: Gottschalk et al

      Gottschalk et al astutely noted that talar osteochondritis dissecans (OCD) >150 mm2 or >15 mm in diameter requires treatment other than microfracture. The use of the osteochondral autograft transfer system involves a second operative site and/or the cost of an allograft. Autologous chondrocyte implantation involves a second surgery and increased cost. The study by Gottschalk et al involves a 1-stage procedure with curettement and drilling or microfracture of the lesion, autogenous bone grafting into the talar OCD, and coverage with a collagen membrane sealed with fibrin glue. To their credit, they reassessed their 21 patients for whom they had complete data at 5 years postoperatively, including repeat studies with magnetic resonance imaging (MRI). Very few studies have performed such reassessments. However, we might receive “push back” from insurance companies on this side of the Atlantic regarding repeat imaging.
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