Abstract:[Objective] To explore the clinical effect of medial malleolus "V" osteotomy and autogenous osteochondral transplantation in the treatment of talus cartilage injury (Osteoc hondral Lesions of the Talus,OLT). [Methods] From January 2018 to June 2020, 24 patients with OLT were treated with medial malleolus "V" osteotomy combined with autologous cartilage transplantation in the ipsilateral femoral condyle. The curative effect was evaluated according to VAS score, ankle AOFAS score, TakakuraandColleagues ankle degeneration grade, cartilage injury repair MOCART score and donor knee joint Lysholm score. [Results] All patients completed the operation successfully and there was no neurovascular injury. The average follow-up period was （24.2±6.6）months. At the last follow-up, VAS score decreased significantly (P < 0.001), AOFAS score and MOCART score increased significantly (P < 0.001), and there was no difference in knee Lysholm score before and after treatment (P = 0.148). The results of imaging examination showed that all osteotomies healed and OLT lesions repaired well, but there was no significant change according to TakakuraandColleagues ankle degeneration grade. [Conclusion] Medial malleolus "V" osteotomy combined with autogenous osteochondral transplantation is safe and reliable in the treatment of talus osteochondral injury. Key words:Osteochondral injury of talus; Autogenous osteochondral transplantation; Non-weight-bearing area of femoral condyle; Osteotomy