The etiology of talar cartilage injuries is not entirely clear. Most patients will have a history of trauma, such as severe ankle trauma, a history of severe ankle sprains, or, in some patients without a significant history of trauma, a symmetrical and simultaneous onset of both ankles. Patients with talar cartilage injuries often have characteristic clinical symptoms, such as pain when walking up and down stairs, pain in a particular position when walking, and pain that lasts for a while or relieves after a few hours. Our doctors will perform a step-by-step examination in the outpatient clinic. The diagnosis is difficult at first stage I and II (stage I and II), but at stage III and IV (stage III and IV), the diagnosis is not difficult. We can use imaging tests. Radiographs (x-ray) If it can be seen on a normal x-ray, it must involve the subchondral bone. Then the next step to confirm the diagnosis is MRI or CT? MRI and CT can both be used, and each has its own strengths, depending on the case. 2.MRI 3.CT Whether it is MRI or CT, it is not difficult to make a diagnosis when it reaches the level shown in the picture above. However, it is often easy to miss the diagnosis at the early stage because it is not visible on x-ray MRI CT. Then some people ask, since the damage is so small that it cannot be seen, is there any point in continuing the diagnosis? The question is that if the patient continues to have symptoms that cause a lot of inconvenience in life, then the diagnosis and treatment becomes meaningful. In this case, the next step is diagnostic ankle arthroscopy, which is also useful for diagnosing and treating other possible pathologies. This type of injury can sometimes only be detected by ankle arthroscopy. It is important for the physician to determine if arthroscopy is needed, and if so, when it is best to communicate with the patient so that the patient fully understands his or her condition and the implications of using arthroscopy. I have done a comparison of MRI and arthroscopy in the diagnosis of cartilage injuries of the talus, entitled “A comparison of arthroscopic and MRI findings in staging of osteochondral lesions of the talus”. “MRI is currently the best method for the diagnosis of cartilage injuries in a non-invasive manner, but there are some limitations. Treatment Treatment also includes conservative and surgical treatment. If conservative treatment fails, surgical treatment is often indicated, although the duration of the disease should be taken into account. Conservative treatment includes immobilization of the short non-ambulatory leg in a cast for 4 weeks, reduced activity, and rest. When surgery is used, the most important decision is based on the size of the injury and, of course, age, height, weight (BMI), and other factors. Arthroscopic Microfracture or Drilling (minimally invasive treatment using arthroscopy) is a slightly more technical approach and is suitable for injuries smaller than 1.5 cm2. The follow-up results are better in more than 80% of patients. The results are presented in the following papers. With this method, the difference in outcome is the difference between hyaline and fibrocartilage. Transparent cartilage is the original cartilage that we were born with, which is considered non-renewable and difficult to repair on its own once it is damaged, and the cartilage formed through minimally invasive surgery is fibrocartilage, which is not as elastic as transparent cartilage, but is sufficient for people with low activity requirements (generally speaking, non-sports professionals are not required to play soccer, basketball, badminton, etc., to maintain The amount of daily life activities). 2.osteochondral graft transplantation-osteochondral autograft transfer system (autologous osteochondral transplantation) Autologous cartilage transplantation is currently one of the more selected procedures. Most of the cartilage sources are non-weight-bearing areas of the distal knee – femur. This is not a difficult procedure for the foot and ankle surgeon and the results are excellent because the graft is hyaline cartilage. It is a good option for patients with relatively high mobility requirements. However, it is important to understand the disadvantages of the procedure, as any surgery has both pros and cons. For patients, they can choose which treatment method to receive according to their condition (age and weight, post-operative activity requirements, size of the injury area, etc.).