距骨骨软骨损伤是运动医学中具有挑战性的疾病之一。临床治疗策略包括保守治疗和手术治疗，保守治疗在儿童患者中效果最佳，对于成人患者常常选择进行手术治疗。目前常见的外科手术治疗方案包括关节镜下骨髓刺激、自体软骨细胞植入、自体骨软骨移植、同种异体骨软骨移植或同种异体青少年软骨微粒移植等。关节镜下骨髓刺激技术(特别是微骨折)适用于较小的病灶，是常见的一线治疗方案，中短期临床疗效令人满意，但长期疗效有待进一步观察。自体骨软骨移植常用于伴有较大囊性病变的距骨骨软骨损伤患者，有着较好的中短期临床疗效，然而术后存在囊肿复发和供区并发症的发生。近年来有大量文献报道其他生物治疗措施，如骨软骨损伤区域注射富含血小板血浆、或者浓缩骨髓细胞等，均有一定的临床疗效。本文对这些技术的应用细节和疗效进行综述，目的是为临床医生能够更好地治疗距骨骨软骨损伤提供依据。

Osteochondral lesions of the talus is one of the challenging diseases in sports medicine. Conservative treatment is often used in pediatric patients. Surgical options are often applied for adult populations whose symptoms may persist with conservative treatment. The current surgical options include arthroscopic subchondral bone marrow stimulation, autologous chondrocyte implantation, autologous osteochondral transplantation, allograft cartilage transplantation or particulated juvenile cartilage allograft transplantation. Arthroscopic bone marrow stimulation (especially microfracture) is the first-line treatment for smaller noncystic lesions. The short- and medium-term of clinical results is good; however, there is a lack of long-term evidence. Autologous osteochondral transplantation applied for lesions with greater area or for cystic lesions. It has showed good short- to medium-term results. However, the subchondral cysts and donor site complication often occurred after surgery. Recent developments have reported the clinical effectiveness of the biological adjuncts such as platelet-rich plasma and concentrated bone marrow aspirate. The purpose of this article is to review the treatment of osteochondral lesions of the talus so that more efficiently treatment strategies can be used by clinicians.