Osteochondral Autograft

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  • Symptomatic focal chondral lesion
  • Unipolar lesion
  • Lesion no larger than 2 to 2.5 cm in diameter
  • Normal appearance of surrounding articular cartilage
  • Age less than 45 years
  • Age over 45 years (relative contraindication)
  • Obvious chondromalacia of the surrounding cartilage
  • Abnormal mechanical alignment
  • Ligamentous instability of the knee
  • Arthroscopy tower and equipment
  • Arthroscopy set including cannulas
  • Osteochondral autograft transfer (OATS) set
  • Mallet
  • Bony anatomy of the knee:
    • Distal femur: most common site of defects; larger medial condyle, smaller lateral condyle
    • Tibial plateau: concave, oval medial surface; convex, circular lateral surface
    • Patella: large sesamoid bone that articulates with the trochlea; chondral defects from direct anterior trauma
  • Articular cartilage: composed primarily of water, collagen, proteoglycans, and chondrocytes; layers include a superficial gliding zone, a middle transitional zone, and a deep radial zone
  • Cortical bone (compact bone) and cancellous bone (spongy or trabecular bone) are found deep to the articular cartilage.

Sample excerpt does not include step-by-step text instructions for performing this procedure
The full content of this section includes:
  • Step-by-step text instructions for performing the procedure
  • Clinical pearls providing practical clinical tips from medical experts
  • Patient safety guidelines consistent with Joint Commission and OHSA standards
  • Links to medical evidence and related procedures

  • Immobilize the knee and allow partial weigh bearing only for 4 to 6 weeks.
  • Prescribe oral pain medication as needed.
  • Begin isometric quadriceps strengthening immediately, with progression of weight-bearing exercise after 6 weeks.
  • Infection
  • Failure of graft to incorporate
  • Donor site pain
  • Continued symptoms
  • Vascular injury
  • Thrombophlebitis
  • Reflex sympathetic dystrophy
  • Neurologic injury

Promising results have been reported, with clinical success rates of at least 85%.

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