I was recently diagnosed with an advanced osteochondral defect of the talus, posteromedially. This was diagnosed with MRI. This also has avascular necrosis, with the defect being quite large. I was told that I may need up to four surgeries to correct this, and my flat feet. They were talking of doing an open osteotomy with bone grafts from the knee. They advised me that they do not recommend surgery until I can no longer stand the pain. Is this normal? Wouldn't you want to correct the defect now while it is easier to fix instead of later when the only option may be joint fusion?