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World J Orthop. May 18, 2026; 17(5): 115855
Published online May 18, 2026. doi: 10.5312/wjo.v17.i5.115855
Published online May 18, 2026. doi: 10.5312/wjo.v17.i5.115855
Cartilage allograft transplantation for challenging medial talar dome osteochondral defects: A retrospective case series utilizing medial malleolar osteotomy
Mohamed M Elalfy, Mohamed Abdelrazek, Department of Orthopedic Surgery, Mansoura University Hospitals, Dakahlia 35516, Mansoura, Egypt
Mohamed M Elalfy, Department of Orthopedic Surgery, Andalusia Hospitals, Jeddah 22341, Makkah Al Mukarramah, Saudi Arabia
Osama M Embaby, Department of Orthopedic Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham B66 2QT, United Kingdom
Osama M Embaby, Department of Orthopedic Surgery, Damietta University, New Damietta 34517, Egypt
Ahmed N Aladl, Department of Orthopedic Surgery, Sana Klinikum Coburg, Ketschendorfer 96450, Germany
Khaled Youssef, Department of Orthopedic Surgery, Southampton General Hospital, Southampton SO16 6YD, United Kingdom
Orjwan Abulaban, Department of Orthopedic Surgery, King Abdulaziz University Hospital, Jeddah 22252, Saudi Arabia
Mohammed H Abushal, Department of Orthopedic Surgery, University of Tabuk, Tabuk 71491, Saudi Arabia
Co-first authors: Mohamed M Elalfy and Osama M Embaby.
Author contributions: Elalfy MM designed the research and performed the surgeries and clinical work; Elalfy MM and Embaby OM supervised the study, and they contributed equally to this manuscript and are co-first authors; Elalfy MM, Embaby OM, Aladl AN, Abdelrazek M, Youssef K, Abulaban O, and Abushal MH contributed to interpretation of data and critical revision of the manuscript for important intellectual content; Embaby OM curated and analyzed the data and wrote the original draft. All authors have read and approved the final manuscript and agree to be accountable for all aspects of the work.
AI contribution statement: AI-assisted tools were used only for language polishing, grammar checking, and improving the clarity/readability of the manuscript.
Institutional review board statement: The requirement for formal ethical approval was waived by the Institutional Review Board of Red Crescent Hospital (Mansoura, Egypt), as this was a retrospective case series of anonymized data. The study was conducted in accordance with the principles of the Declaration of Helsinki.
Informed consent statement: The requirement for individual informed consent was waived by the Institutional Review Board of Red Crescent Hospital (Mansoura, Egypt), as this retrospective case series used anonymized clinical and imaging data.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Data supporting the findings of this study are available from the corresponding author upon reasonable request.
Corresponding author: Mohamed M Elalfy, MD, Foot and Ankle Surgery Consultant, Department of Orthopedic Surgery, Mansoura University Hospitals, El Gomhoureya Street, Dakahlia 35516, Mansoura, Egypt. drmelalfy@mans.edu.eg
Received: October 28, 2025
Revised: November 17, 2025
Accepted: January 29, 2026
Published online: May 18, 2026
Processing time: 203 Days and 9.4 Hours
Revised: November 17, 2025
Accepted: January 29, 2026
Published online: May 18, 2026
Processing time: 203 Days and 9.4 Hours
Core Tip
Core Tip: This retrospective study evaluated 23 patients with symptomatic osteochondral defects of the medial talar dome treated using cartilage allograft transplantation following medial malleolar osteotomy. The technique combined defect drilling, bone marrow aspirate application, and fibrin glue fixation to enhance graft stability and integration. Significant improvements were achieved in American Orthopaedic Foot and Ankle Society score, Visual Analogue Scale for pain, and Magnetic Resonance Observation of Cartilage Repair Tissue score. This single-stage approach provides a safe, effective, and biologically supported solution for large medial talar dome osteochondral defects.