Autologous osteochondral graft as treatment for gouty tophus in the talus

Rationale: Gout can cause redness, swelling, local heat, severe pain, and limitation of function of the affected joints and surrounding tissues. Gouty tophi are commonly found in the auricle, joints, Achilles tendon and tarsal bursa. However, gouty tophi rarely affect the talus. Patient concerns: We report a case of a 35-year-old man with a history of a sprained left ankle (six years before presentation), who presented with atraumatic and progressive pain, which the patient has been experiencing for a year. Diagnosis: The patient was diagnosed with ankle pain with a gouty stone in the talus. Interventions: The patient was treated with autologous osteochondral transplantation. Outcomes: During the two-year follow-up period, the patient's ankle joint underwent functional recovery and pain relief. Furthermore, the patient's Baird-Jackson ankle score improved from 80 to 95. Lessons: The gold standard for the diagnosis of gouty tophus in the talus is intraoperative arthroscopy and pathology. The presented case achieved satisfactory clinical effects with autologous osteochondral transplantation as the treatment for gouty tophus in the talus, and obtained an ideal hyaline cartilage repair with restored ankle joint function.