The medial ankle compartment is defined by the medial malleolus laterally, the medial talar dome superiorly, and the medial capsule and deltoid ligament medially. It is assessed via the anteromedial arthroscopic portal and is the site of medial talar dome osteochondral lesions.
Medial ankle compartment pathology includes medial talar OCD, medial gutter impingement, and deltoid ligament tears accessible via the anteromedial portal. Medial talar OCD lesions are typically cup-shaped, posteromedial in location, and larger than lateral lesions. Retrograde drilling or autologous chondrocyte implantation targets the subchondral bone of the medial compartment.
Osteochondral defect of the medial talar dome in the medial ankle compartment producing medial ankle pain with activity, graded by MRI and treated by arthroscopic debridement, microfracture, or OAT grafting depending on size.
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