Procedure
OATS
For Osteochondral Lesion of the Talus
What It Involves
OATS (Osteochondral Autograft Transfer System) is a major cartilage repair procedure used for larger osteochondral lesions of the talus, where microfracture alone is unlikely to give a durable result. A cylindrical plug of healthy bone and cartilage is harvested from a less load-bearing area of the knee and transplanted into the prepared talar defect, restoring a true hyaline cartilage surface rather than the fibrocartilage produced by microfracture.
This is a more extensive operation than microfracture, involving a second surgical site at the knee graft harvest, and is performed under general or regional anaesthesia.
Benefits
- Restores a true hyaline cartilage surface, which is more durable than the fibrocartilage produced by microfracture, and is suited to larger defects where microfracture is unlikely to succeed.
- Uses your own tissue — there is no risk of graft rejection.
Recovery Timeline
Everyone heals at a different rate. This timeline is a guide.
Weeks 1–2
Non-weight-bearing in a cast, with the foot elevated to control swelling. The wound is checked and sutures removed at 2 weeks.
Weeks 2–6
Transition into a boot, remaining non-weight-bearing through to 6 weeks to protect the graft while it integrates.
Weeks 6–12
Graduated weight-bearing commences once healing is confirmed on X-ray, with physiotherapy for range of motion, strength, and gait.
3 months
Return to low-impact activity, with running and higher-impact sport introduced gradually from this point guided by symptoms and physiotherapy progress.
6–12 months
Given the nature of graft integration in the ankle, full return to running and higher-impact sport is expected to take 6–12 months minimum, with a final review and discharge once achieved.