Background: The indications of osteochondral autograft implantation using the Mosaicplasty (R) technique were only recently extended to osteochondral lesions of the talus (OLT), a site for which no medium- or long-term outcome data are available. Our objective here was to evaluate medium-term outcomes in case-series of patients who underwent Mosaicplasty (R) for OLT repair. Hypothesis: Mosaicplasty (R) provides good medium-term outcomes with low morbidity when used for OLT repair. Patients et methods: We retrospectively reviewed cases of Mosaicplasty (R) for OLT repair, performed in combination with malleolar osteotomy on the side of the OLT, at either of two centres, between 1997 and 2013. Pre-operative clinical data were collected from the medical records and all patients were re-evaluated. We studied 37 patients with a mean age of 33 years. Results: Mean follow-up at re-evaluation was 76 months. Mean AOFAS score at re-evaluation was 83( range, 9-100). A work-related cause to the OLT was associated with significantly poorer outcomes( P = 0.01). AOFAS values were significantly better in patients whose OLT size was 0.5 to 1 cm(2). The Ogilvie-Harris score at last follow-up was good or excellent in 78% of patients. No patient experienced morbidity related to the malleolar osteotomy. Persistent patellar syndrome was noted in 6 patients. Discussion: In our case-series, Mosaicplasty (R) for OLT repair provided good medium-term outcomes in 78% of patients. Nevertheless, the donor-site morbidity should be borne in mind. Mosaicplasty (R) deserves to be viewed as a reference standard method for OLT repair. (C) 2014 Elsevier Masson SAS. All rights reserved.