Dr. So of OIG published a systematic review in the Journal of Foot and Ankle Surgery. The paper is entitled, “A Comparison of Outcomes of Revision Surgical Options for the Treatment of Failed Bulk Talar Allograft Transfer: A Systematic Review”. Talar bulk osteochondral allograft for the treatment of large, uncontained osteochondral lesions of the talus can result in improved outcomes. However, there is still a considerable failure rate. Treatment options are limited to fusion, revision allograft, and total ankle arthroplasty. In this systematic review, we compare those treatment options for this difficult problem.