https://doi.org/10.1177/1071100720942173 Foot & Ankle International® 1–8 © The Author(s) 2020 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/1071100720942173 journals.sagepub.com/home/fai Article Osteochondral lesion of the talus (OCLT) is a well-recog- nized entity associated with chronic ankle pain. 2 OCLTs rep- resent a difficult management problem, and the true incidence of these injuries is unknown. 16 In clinical practice, nonopera- tive treatment is generally indicated for acute, nondisplaced lesions in early stages. On the other hand, operative treatment is considered for symptomatic lesions if any recovery cannot be seen in magnetic resonance imaging (MRI) during 3 to 6 months of follow-up. 5 Operative treatment modalities have evolved through the years, especially by the evolution of arthroscopic treatment. 7 Recently, the generally accepted ini- tial operative treatment of the OCLT is arthroscopic debride- ment and bone marrow stimulation (microfracture). 22 Microfracture (MF) provides infiltration of the lesion by bone marrow progenitor cells to stimulate the formation of fibrocartilage. 3 In a recent systematic review, Dahmen et al 4 reported that bone marrow stimulation for OCLT yielded a success rate of 82% (confidence interval, 78-86). 942173FAI XX X 10.1177/1071100720942173Foot & Ankle InternationalCamurcu et al research-article 2020 1 Department of Orthopaedics and Traumatology, Erzincan Binali Yildirim University Faculty of Medicine, Erzincan, Turkey 2 Department of Orthopaedics and Traumatology, Yalova State Hospital, Yalova, Turkey 3 Department of Orthopaedics and Traumatology, Kayseri City Hospital, Kayseri, Turkey 4 Department of Orthopaedics and Traumatology, Selahaddin Eyyubi State Hospital, Diyarbakir, Turkey 5 Department of Orthopaedics and Traumatology, Altinbas University Bahcelievler Medicalpark Hospital, Istanbul, Turkey Corresponding Author: Yalkin Camurcu, MD, Department of Orthopaedics and Traumatology, Erzincan Binali Yıldırım University, Basbaglar Mahallesi, Erzincan, 24100, Turkey. Email: yalkin.camurcu@gmail.com Clinical and Magnetic Resonance Imaging Outcomes of Microfracture Plus Chitosan/ Blood Implant vs Microfracture for Osteochondral Lesions of the Talus Yalkin Camurcu, MD 1 , Hanifi Ucpunar, MD 1 , Furkan Yapici, MD 1 , Resit Karakose, MD 1 , Seckin Ozcan, MD 2 , Adem Cobden, MD 3 , Serda Duman, MD 4 , and Hakan Sofu, MD 5 Abstract Background: The aim of this study was to compare the clinical and magnetic resonance imaging (MRI) outcomes of arthroscopic microfracture (MF) plus chitosan-glycerol phosphate/blood implant and MF alone for the treatment of the osteochondral lesions of the talus (OCLTs). Methods: Patients who underwent either MF plus chitosan (group 1, n = 32) or MF alone (group 2, n = 31) between 2015 and 2019 in 2 separate time periods were retrospectively analyzed. Visual analog scale (VAS) score and American Orthopaedic Foot & Ankle Society (AOFAS) score were used for clinical evaluation. The magnetic resonance observation of cartilage repair tissue (MOCART) system was used for MRI evaluation. The mean follow-up time was 32 ± 13 months (range, 12-61 months). Results: Postoperatively, we detected significant improvements in both groups in terms of VAS and AOFAS scores. However, we observed no statistically significant difference between groups in terms of clinical scores, except the mean VAS function score, which was significantly higher in group 1 (P = .022). According to MOCART scale, complete repair with the filling of the chondral defect and intactness of the surface of the repair tissue were more common in group 1. However, these parameters did not significantly differ between groups (P = .257 and .242, respectively). Conclusion: Arthroscopic MF plus chitosan glycerol phosphate/blood implant did not result in better clinical and MRI outcomes compared with MF alone in the treatment of OCLTs. Level of Evidence: Level III, retrospective comparative study. Keywords: arthroscopy, microfracture, osteochondral lesion, talus, chitosan-glycerol phosphate, blood implant