Osteochondral graft from the pre-Achilles area for repair of ankle joint articular surface defects and lesions

Introduction Management of osteochondral lesions of the talus trochlea involves surgical debridement of the necrotic cartilage and underlying bone, and then repair of the defect with an osteochondral autologous graft. The use of MSCT, MRI allows us to detect changes in the ankle joint at the initial stage, when the salvage operation is effective. Purpose Histological substantiation of the possibility to use osteochondral autologous grafts from the pre-Achilles area of the calcaneus for management of osteochondral defects in the damaged talus trochlea. Material and methods We substantiate a new technique for obtaining an osteochondral autologous graft to repair osteochondral defects of the talar trochlea resulting from various lesions by means of a morphological study of the following microslides: cartilage and underlying bone tissue of the talar trochlea (cadaver material), necrotic area of the talus, and the cartilage portion of the pre-Achilles area of the calcaneus. For comparison, preparations of the cartilage tissue from the lateral condyle of the femur were investigated. Results Investigations of the specimens of the pre-Achilles cartilage of the calcaneus revealed a large number of chondrocytes in the extracellular matrix, presence of its all cartilage zones (superficial, middle, and deep ones). This was a proof that this cartilage was preserved both structurally and functionally. Conclusion On the basis of the findings, it is assumed that pre-Achilles area cartilage can be considered as an autograft material.