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Throughout history, several techniques and treatment modalities have been used in the management of these lesions with an ongoing debate as to which approach is superior to the other, and what the indications and rehabilitation protocols are for each modality. Moreover, the introduction of adjunct therapies such as extracorporeal shockwave therapy and injectables widened the scope of the treatment. While most surgical and nonsurgical approaches have demonstrated satisfactory outcomes, an ideal treatment algorithm is still elusive. This literature review meticulously studies major trends in the different management techniques of osteochondral lesions of the talus, describing the mostly used protocols, comparative results, and complication rates. It also highlights the latest updates on the use of injectables and adjunct therapies, aiming to guide the clinical decision making in treating this pathology.<\/jats:p>","DOI":"10.1177\/10225536261476345","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T08:51:32Z","timestamp":1786092692000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Restoring the talar dome: A comprehensive review of treatment options for osteochondral lesions in adults"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0690-5519","authenticated-orcid":false,"given":"Raymonde","family":"Dahdouh","sequence":"first","affiliation":[{"name":"University of Balamand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim","family":"Areslan","sequence":"additional","affiliation":[{"name":"University of Balamand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Atallah","sequence":"additional","affiliation":[{"name":"University of Balamand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luna Maria","family":"Khalil","sequence":"additional","affiliation":[{"name":"University of Balamand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad","family":"Badra","sequence":"additional","affiliation":[{"name":"University of Balamand"},{"name":"Clemenceau Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramzi","family":"Moucharafieh","sequence":"additional","affiliation":[{"name":"University of Balamand"},{"name":"Clemenceau Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2020.10.002"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/1947603520985182"},{"key":"e_1_3_4_4_2","first-page":"988","article-title":"Transchondral fractures (osteochondritis dissecans) of the talus","volume":"41","author":"Berndt AL","year":"1959","unstructured":"Berndt AL, Michael H. 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