Can a talar osteochondral injury be cured without surgery? ”This is the attitude of the majority of patients towards the treatment of their disease. So, is it possible to treat osteochondral injuries of the talus without surgery? Are conservative treatments such as medication, physical therapy and plasters effective? In fact, not all patients with osteochondral injuries of the talus need surgery. Patients with mild symptoms, as well as elderly people who do not require high mobility, can be treated conservatively. Although it is not curative, it can curb the progression of the disease and provide significant pain relief. In addition, it is theoretically impossible for the injured cartilage to heal completely, but if the patient is in adolescence and has some specific type of injury, the cartilage may partially heal after conservative treatment. It is important to note that cartilage injury, whether in the elderly or in children, does not regenerate and does not regrow normal hyaline cartilage. So what are the conservative treatment modalities for osteochondral injuries of the talus? There are three broad categories: activity restriction, medication, and physical therapy. Restriction of activity is the main method, and the specific methods include: recommending that the patient does not participate in sports activities; allowing the patient to walk down with crutches and partially bear weight; and in severe cases, a cast is needed to keep the injured foot completely immobile and off the ground. The specific method to be used needs to be analyzed according to the condition. As for the need to wear an ankle brace to protect the injured part, generally speaking, if the doctor judges that there is no ligament damage, the patient does not need to wear an ankle brace, but only if there is ligament damage. In addition to limiting activities, medications can be used to reduce the pain of cartilage injuries in the talus, both topical and oral. If there is no cast, patients usually prefer to apply plasters, and many patients also soak their feet with a mixture of herbs every day. However, for osteochondral injuries of the talus, the efficacy of herbal foot soaks is mainly to relieve pain, and it is still debatable whether it is useful for cartilage healing. In addition to the external application of Chinese medicine, many patients use anti-inflammatory and analgesic creams such as Fotarine, which can relieve pain, but not cure the disease. It is worth noting that there are two types of external compresses: cold and hot. If the swelling of the affected area is obvious and the disease is in the acute stage, cold compresses are needed. Only after the swelling has subsided and the disease has become chronic can hot compresses be started. Generally, the acute period is three weeks, i.e. cold compress within three weeks; three weeks to three months is the subacute period, after which the disease becomes chronic and can be switched to hot compress. In addition to topical medications, some non-steroidal anti-inflammatory and analgesic drugs can also be taken orally, such as oral fotarine (diclofenac sodium). It is worth noting that these drugs are best taken according to the condition and according to the course of treatment, rather than only when pain occurs. In addition, many patients are very concerned about the use of glucosamine as well as hyaluronic acid. In fact, it has not been conclusively determined whether oral glucosamine has a role in the repair of cartilage damage. If patients wish to take such medications, we believe they are more appropriate for use after surgery for osteochondral injury of the talus, because after surgery patients need to grow new cartilage (a cartilage substitute, also known as fibrocartilage), of which glucosamine is a component. Before surgery, the cells that form fibrocartilage do not effectively repair cartilage, so taking glucosamine may not work. As for hyaluronic acid, it is more suitable for use in cases of osteoarthritis. Activity restriction and medication are the two main tools for conservative treatment of osteochondral injury of the talus, in addition, the effect of physical therapy should not be ignored. For example, ultrashort wave therapy is commonly used to improve blood circulation to the affected area and eliminate inflammation. Generally, ultrashort wave treatment takes about ten days, once a day, and the doctor needs to be consulted after the treatment to determine the subsequent treatment plan according to the specific condition. As for extracorporeal shock wave treatment for osteochondral injury of the talus, there is still some controversy. Theoretically, the principle of extracorporeal shock wave is to focus energy to the deeper subchondral bone in the body to improve the blood circulation there. However, there is no clinical research data to prove the efficacy of this approach.