40 patients with recurring or large (>1.5 cm^2) osteochondral lesions of the talar dome (OLT) were randomized to receive either autograft or allograft osteochondral plugs following tear excision. The purpose of this study was to determine if there were any significant differences between autograft or allograft transplantation when evaluated by radiographic assessment and changes in ankle pain and function scores over a minimum of 1 year follow-up. Results demonstrated that all outcome measures were comparable between study groups, as both transplantation methods resulted in high rates of osteochondral healing after follow-up period was completed.