This narrative review aims to present the current concepts about classification,diagnosis and treatment of osteochondral lesions of the talus (OCL).OCL is a more common source of ankle those previously recognised and often present as complications of ankle injuries.No time restriction was applied in the English literature search in Pubmed and EMBASE,and focus was laid on the classification,diagnosis and treatment of OCL.An acute OCL will mimic the clinical picture of a sprained ankle,therefore if symptoms persist after 2~3 weeks,AP,lateral and mortise X-Ray views of the ankle are indicated.If these are negative,a CT scan will rarely miss the lesion,but the most accurate imaging is the MRI,which can accurately assess cartilage damage.Debridement and bone marrow stimulation is according to available information,the surgical technique which currently yields best results for small lesions(<15 mm) while ACI or osteochondral transplantation are recommended by several authors for large lesions.In view of OCL are easily missed in clinical practice,we recommend that there should be a high index of suspicion especially in forceful inversion injuries of ankle in dorsiflexion or plantarflexion.
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