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Treatment of Osteochondral Lesions of the Talus with a Biosynthetic ScaffoldA Report of Four Cases
E'Stephan J. Garcia, MD1; Russell R. Bear, DO1; Andrew J. Schoenfeld, MD1; Brett D. Owens, MD2
1 Department of Orthopaedic Surgery, William Beaumont Army Medical Center, Texas Tech University Health Sciences Center, 5005 North Piedras Street, El Paso, TX 79920. E-mail address for E.J. Garcia: estephan.garcia@amedd.army.mil
2 Department of Orthopaedic Surgery, Keller Army Community Hospital, 900 Washington Road, West Point, NY 10996-1197
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

Investigation performed at William Beaumont Army Medical Center, Texas Tech University Health Sciences Center, El Paso, Texas
Disclaimer: The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the Department of Defense or United States government. The authors are employees of the U.S. government. No funding was received for this study.

Copyright ©2010 American Society for Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2010 Jul 21;92(8):1774-1779. doi: 10.2106/JBJS.I.01470
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Extract

The management of recurrent and large cystic osteochondral lesions of the talus presents a challenge to orthopaedic surgeons. Although numerous treatment options are available, few publications exist that provide guidance regarding management. The initial management of stage-I and stage-II lesions1,2 is typically nonoperative. However, for persistent or advanced talar lesions, surgical intervention is common3-5. Surgical options traditionally include arthroscopic debridement with or without microfracture, internal fixation of larger fragments, or retrograde drilling with bone-grafting. When initial surgical management has failed or when larger lesions are present, patients may be treated with an osteoarticular transfer system, mosaicplasty, bulk allograft, or autologous chondrocyte implantation6.
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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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