Hydrogel and scaffold strategies for talar osteochondral repair: biofabrication, ankle biomechanics, and clinical translation
Year: 2026
Type: review
Abstract: Osteochondral lesions of the talus combine focal cartilage injury with variable subchondral bone damage in a small, highly loaded joint, making successful biomaterial translation dependent on more than regenerative capacity alone. This review examines hydrogel, scaffold, and biofabrication strategies for talar osteochondral repair through the combined lenses of ankle biomechanics, spatial construct design, and clinical feasibility. Defect containment, shoulder involvement, cystic depth, instability, and alignment alter the requirements for conformal filling, wet-field retention, cyclic compression and shear tolerance, and cartilage-bone anchorage. Recent biofabrication approaches, including gradient and multilayer scaffolds, 3D-printed architectures, decellularized extracellular-matrix hydrogels, directional microchannels, and adhesive or bioactive systems, provide increasing control over spatial organization and mechanical transitions, but most remain preclinical. Human studies support the feasibility of matrix- and scaffold-assisted talar repair, including autologous matrix-induced chondrogenesis, collagen- and hyaluronic acid-based platforms, cell-supported constructs, and related one-step procedures; however, heterogeneous lesion selection, concomitant bone grafting, instability correction, rehabilitation, imaging, and follow-up limit direct material-level comparisons. The central translational question is whether a material architecture addresses the dominant mechanical and surgical requirements of a defined talar lesion. Evaluation should therefore integrate wet-field handling, edge and interface stability, cyclic loading, bone-side integration, degradation under load, manufacturing reproducibility, and lesion-stratified clinical outcomes.
Source: Frontiers in Surgery
Authors: Qi Zhu, Zhengyu Liu, Beibei Chen, Jun Cui
Language: English
Topic: Foot and Ankle Surgery
Subfield: Orthopedics and Sports Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7223176405