Clinical and functional outcomes of arthroscopic autologous collagen-induced chondrogenesis (ACIC) for osteochondral lesions of the talus: A retrospective case series.

Purpose: The aim of this retrospective study was to assess the clinical outcomes for osteochondral lesions of the talus (OLT) treated with all arthroscopic autologous collagen-induced chondrogenesis (ACIC) technique using an injectable collagen scaffold combined with microfractures. Methods: Between 2020 and 2023, 21 patients with Hepple Grade II-IV OLTs underwent arthroscopic ACIC technique using an injectable collagen scaffold combined with microfractures. Concomitant intra-articular pathologies identified during arthroscopy were addressed simultaneously. Clinical outcomes, including Visual Analogue Scale (VAS), Foot Functional Index (FFI) and Foot and Ankle Ability Measure-Sports subscale (FAAM-SS), were assessed preoperatively and at the latest follow-up. Patient expectations, complications and return-to-activity times were also recorded at final follow-up. Results: The mean follow-up was 37.4 ± 20.7 (range, 13-68) months. The mean defect size was 76.6 ± 33.6 mm Conclusions: Arthroscopic ACIC with an injectable atelocollagen scaffold was feasible and safe in this series of Hepple II-IV OLT, yielding improvements in patient‑reported outcomes at a mean 37.4‑month follow‑up. Due to design limitations and frequent concomitant ligament stabilization, these findings should be considered hypothesis‑generating rather than definitive evidence of cartilage regeneration. Level of Evidence: Level IV, retrospective case series.