I remembered going through this thread about a year ago when I was diagnosed with and OCD, and thought I'd add my experience. I was having pain in my ankle that gradually worsened over months, until the point where I couldn't walk w/o a cam boot due to pain. I delayed imaging for several months because I thought it was just posterior tibialis tendonitis. When it didn't heal, I finally relented and got and MRI which showed a very large OCD, about the size of a quarter on my Talus. I first saw a podiatrist who offered microfracture surgery only. That didn't sound like a great idea so I went to a sports med guy. We talked about DeNovo and an OATS procedure as my main options. My insurance wouldn't approve DeNovo, and a few other foot and ankle orthopods I talked to said my lession was too big for DeNovo anyway, so OATS it was. I researched it, and from the studies I found, >80% of people who had the procedure done reported good outcomes 2 years out. He trimmed away the damaged cartilage, did microfracture, then took a graft from my knee and placed it over the defect. What I wasn't expecting was the morbidity in my knee. He had to cut through my quad to get to the cartilage. My quad strength really suffered initially (it was a few weeks before I could contract my quad even slightly w/o severe pain) and has gradually improved but it's still not 100% a year out. Had I known this would be the case, I would have opted for a cadaver donor in order to spare the knee/quad. As for the ankle, I started running about 6 months after the surgery, and I just ran 12 miles last week (split over three days) without any pain. I also got out to the track and did some (slow) strides for the first time last week, again without pain. I am limited by a weak calf and quad, as well as decreased ROM in the ankle which combined have really limited any explosion, but it is still improving.
Overall, I'm happy with the results so far, since I couldn't walk w/o pain before the surgery, and now I'm running without pain. If DeNovo is an option for you, I'd say that is the best option. Otherwise, the OATS procedure seems to work well