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. Because your own tissue is used, 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.