*3.2.2.1 Osteochondral allograft case 1*

A 45-year-old male presented to us with 1 year of posteromedial right ankle pain. He reported pain related to physical activities, with a history of previous trauma, swelling of the joint, no feeling of instability, or joint blockage. Physical examination showed diffuse tenderness of the joint during maximal flexion and areas sensitive to touch in the medial tibiotalar joint line with negative ankle stability test (**Figures 5** and **6**).

The patient did not show good evolution with nonoperative treatment; a mosaicplasty with medial malleolus osteotomy was indicated (**Figures 7**–**11**).

The patient progressed well and returned the physical activities, including running without pain in the 6 month postoperatively.

**Figure 1.**  *Image arrival to the service.* 

*Reconstruction with Joint Preservation DOI: http://dx.doi.org/10.5772/intechopen.84354* 

**Figure 2.**  *Immediate postoperative.* 

**Figure 3.**  *An 18th month of evolution.* 

**Figure 4.**  *Final result.* 

#### **Figure 5.**

*Osteochondral lesion with cystic formation in the domus talar medialis measuring 1.0 × 0.7 × 0.7 cm, surrounded by area of bone edema. Stage V by Berndt & Harty.* 

**Figure 6.**  *Osteochondral lesion contained in zone 7 of Raikin.* 

*Reconstruction with Joint Preservation DOI: http://dx.doi.org/10.5772/intechopen.84354* 

**Figure 8.**  *Intraoperative image of cartilage defect removal.* 

**Figure 9.**  *Removal of the cylinder from the lateral superior region of the femoral trochlea (donor area).* 

**Figure 10.**  *Osteochondral cylinders inserted perpendicularly to the receiving surface.* 
