Osteochondral Allograft Transplantation of the Medial Femoral Condyle With Orthobiologic Augmentation and Graft-Recipient Microfracture Preparation

Osteochondritis dissecans (OCD) has been recognized for over 100 years yet still poses treatment challenges owing to both the avascular nature of articular cartilage and the inability to generate hyaline cartilage. The knee is most commonly involved, and without repair, patients have chronic knee pain, loose bodies, and early-onset osteoarthritis. There are a number of surgical techniques for repairing OCD, some of which are still being refined. Currently, common procedures used to treat OCD lesions include microfracture, autologous chondrocyte implantation, osteochondral autograft transplantation, and osteochondral allograft transplantation. In this Technical Note, we describe osteochondral allograft transplantation with the addition of platelet-rich plasma and graft-recipient microfracture. We believe the micropores augment the osteoconductive and osteoinductive properties of the allograft and aid in the incorporation of the allograft plug by improving angiogenesis, enhancing clot formation in the allograft, and providing a homogeneous environment for remodeling.