Autologous Osteochondral Transplantation to Treat Patellar Chondral Injuries.

Introduction: Autologous osteochondral transplantation for the treatment of patellar chondral injuries is a single-stage procedure through a single surgical approach that allows replacement of the chondral injury with an osteochondral plug that has the same cartilaginous hyaline characteristics as the site had before the injury.

Step 1 Preoperative Planning: Make radiographs (anteroposterior, lateral, and Merchant patellofemoral views), computed tomography scans, and magnetic resonance imaging (MRI) of the knee for an anatomic study and to determine cartilage lesion details.

Step 2 Perform Knee Arthroscopy And Lesion Identification: Classify and locate the cartilage lesion on the basis of the intraoperative arthroscopic knee evaluation.

Step 3 Use A Parapatellar Approach: Perform a parapatellar incision and patellar eversion as they are necessary to access cartilage lesions.

Step 4 Harvest The Osteochondral Plug At The Donation Site: Harvest an appropriate osteochondral graft, which is essential for a successful procedure. Perpendicular graft harvesting is crucial for a perfect cartilage surface match.

Step 5 Characterize And Prepare The Lesion: At this point, prepare the receptor area with a power drill.

Step 6 Insert The Osteochondral Plug Into The Receptor Site: Insert the graft with press-fit fixation.

Step 7 Postoperative Care: Instruct all patients to follow a rehabilitation protocol.

Results: Our clinical experience with this procedure has corresponded to the scores and MRI-based findings in our original study, in which we prospectively evaluated thirty-three knees in patients who underwent autologous osteochondral transplantation for a symptomatic full-thickness cartilaginous injury on the patellar articular surface.IndicationsContraindicationsPitfalls & Challenges.