Microfracture vs. Microfracture and BMAC for Osteochondral Lesions of the Talus

Osteochondral lesions of the talus are thought to be due in large part to traumatic events or
repetitive microtrauma that causes damage to both the articular cartilage and the subchondral
bone. There are several treatment modalities for osteochondral lesions of the talus but there
is no consensus as to which is the superior method for repair.

Treatment modalities are aimed at regenerating articular cartilage. Microfracture is a widely
accepted and utilized treatment for osteochondral lesions. This procedure results in
pluripotent bone marrow stem cells filling the defect and ultimately differentiating into
fibrocartilage-producing cells [1]. This technique has shown good results in both short- and
medium-term follow-up for smaller lesions. Bone marrow aspirate contains mesenchymal stem
cells and growth factors with cartilage regeneration potential. Bone marrow aspirate
concentrate (BMAC) is a treatment modality that has shown to have to potential to produce
hyaline cartilage. This study aims to analyze the effect of adding BMAC to the standard
microfracture procedure in terms of clinical and radiographic outcomes in comparison to
patients who only underwent microfracture treatment.