The paper presents the early results of cartilage defect repair of the talar dome performed in 4 patients who were treated, using Biological reconstruction technique. The Follow-up was completed between 18 and 24 months. The treatment consists in restoring the individual layers of the defect, using biological materials, which is being rebuilt, and integrates with the surrounding tissue. Bone defect was restored by allogeneic bone chips impregnated with autologous bone marrow concentrate and fibrin glue. The layer of cartilage was reconstructed using xenogeneic collagen matrix that prior to implation was soaked with bone marrow concentrate as well. The matrix was stabilized with fibrin glue. The work is a preliminary report, including the observation of four patients (3M, and 1F) who underwent the repair of the talar dome defect with the above-described own technique. two of four patients underwent diagnostic arthroscopy during the removal of the medial malleolus fixation hardware within 1 year after surgery. In a recent clinical study, significant improvement was achieved in the evaluation by VAS (from 5.7 to 1.4) and AOFAS (from 45 to 87).