Osteochondral Lesion of Talus: Role of Bone Marrow Aspirate Concentrate and Microfracture—What Does the Current Literature Say?

Osteochondral lesions (OCL) are increasingly being identified at present. These lesions include both osteochondritis dissecans (OCD) and osteochondral fractures. Improved diagnostic modalities, like magnetic resonance imaging (MRI), have become more effective in accurately identifying and quantifying these lesions. While lesions that are small and have some attachment with the rest of the bone respond well to nonoperative treatment, those that are larger in size and those who have failed a trial of nonoperative treatment are recommended to undergo surgical management. Many surgical options have been described. Of these, microfracture (MF) has been extensively used. This procedure results in the release of bone marrow and stimulation of cells to produce fibrocartilage. Additionally, orthobiologics like platelet-rich plasma (PRP) and bone marrow aspirate concentrate (BMAC) have been used to further enhance the healing response. This review attempts to bring forth the available literature on the use of MF and BMAC in the treatment of OCL.