title: Arthroscopic Surgical Technique for an Acute Talar Dome Osteochondral Lesion in a Professional Rugby League Player.
abstract: BACKGROUND
  Talar osteochondral lesions represent challenging clinical entities, particularly in high-demand athletes. Surgical treatment of large lesions often requires a 2-step procedure, or the use of osteotomy in the case of autologous osteochondral transfer, which can delay return to sport.
  
  
  METHODS
  A professional rugby league player underwent surgery for a complex injury to the ankle. A talar osteochondral lesion with a maximal diameter of 15 mm was treated in an arthroscopic fashion using the cartilage taken from the completely displaced osteochondral fragment. Cartilage was cut into chips and combined with bone graft product containing platelet-derived growth factor and a porous collagen scaffold. Autologous cartilage was then reimplanted arthroscopically. The patient was allowed full ankle motion from 2 weeks postoperatively, and weightbearing was commenced at 6 weeks. Follow-up imaging and functional outcomes, including return to sport, were assessed at regular intervals.
  
  
  RESULTS
  The patient was able to return to professional rugby league by 23 weeks postoperatively. Magnetic resonance imaging at 16 months postoperatively showed restoration of the subchondral plate and osseous infill. At final follow-up, the patient remained pain free and was playing at preinjury level.
  
  
  CONCLUSIONS
  This report describes good outcomes using a novel, 1-step cartilage repair technique to treat a large talar osteochondral lesion in a professional athlete.
  
  
  METHODS
  Level V: Expert opinion.
authors.affiliation: St Vincent's Clinic, Sydney, New South Wales, Australia (MS, EJF).|Castlereagh Imaging, Westmead, New South Wales, Australia (JL).|Norwest Imaging, Penrith, New South Wales, Australia (CH).|Penrith Panthers National Rugby League Club, Sydney, New South Wales, Australia (KM).
authors.forename: Martin
authors.initials: M
authors.lastname: Sullivan
authors.affiliation: St Vincent's Clinic, Sydney, New South Wales, Australia (MS, EJF).|Castlereagh Imaging, Westmead, New South Wales, Australia (JL).|Norwest Imaging, Penrith, New South Wales, Australia (CH).|Penrith Panthers National Rugby League Club, Sydney, New South Wales, Australia (KM).
authors.forename: Ethan J
authors.initials: EJ
authors.lastname: Fraser
authors.affiliation: St Vincent's Clinic, Sydney, New South Wales, Australia (MS, EJF).|Castlereagh Imaging, Westmead, New South Wales, Australia (JL).|Norwest Imaging, Penrith, New South Wales, Australia (CH).|Penrith Panthers National Rugby League Club, Sydney, New South Wales, Australia (KM).
authors.forename: James
authors.initials: J
authors.lastname: Linklater
authors.affiliation: St Vincent's Clinic, Sydney, New South Wales, Australia (MS, EJF).|Castlereagh Imaging, Westmead, New South Wales, Australia (JL).|Norwest Imaging, Penrith, New South Wales, Australia (CH).|Penrith Panthers National Rugby League Club, Sydney, New South Wales, Australia (KM).
authors.forename: Craig
authors.initials: C
authors.lastname: Harris
authors.affiliation: St Vincent's Clinic, Sydney, New South Wales, Australia (MS, EJF).|Castlereagh Imaging, Westmead, New South Wales, Australia (JL).|Norwest Imaging, Penrith, New South Wales, Australia (CH).|Penrith Panthers National Rugby League Club, Sydney, New South Wales, Australia (KM).
authors.forename: Kieran
authors.initials: K
authors.lastname: Morgan
mesh_terms: D000208:Acute Disease; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D001182:Arthroscopy / Q000379:methods*; D016025:Bone Transplantation / Q000379:methods*; D002358:Cartilage, Articular / Q000601:surgery; D005538:Football; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010027:Osteotomy / Q000379:methods*; D013628:Talus / Q000000981:diagnostic imaging / Q000601:surgery*; D014182:Transplantation, Autologous; D055815:Young Adult
keywords: ankle; cartilage injury; cartilage surgery; chondral; osteochondral; return to sport; rugby; talus