Fresh Precut Osteochondral Allograft Core Transplantation for the Treatment of Femoral Cartilage Defects

Fresh osteochondral allograft (OCA) transplantation is a successful single-stage procedure for the treatment of symptomatic cartilage defects of the knee. Although long-term studies reveal reliable improvements in patient-reported outcome scores and graft survival, the limitations of the procedure include graft availability and timely use prior to expiration. To avoid prolonged surgical wait times and progression of lesion size, some surgeons have employed the use of nonorthotopic grafts (e.g., lateral femoral condyle graft for a medial femoral condyle lesion). Additionally, fresh precut OCA cores can be used for smaller symptomatic lesions, thereby precluding surgical delays associated with donor-recipient size matching. We describe our preferred technique for the use of fresh precut OCA cores for the treatment of small osteochondral defects of the knee. The distinct advantages of this technique include single-stage restoration of the articular surface without the donor site morbidity observed with osteochondral autograft transplantation.