Osteochondral Allograft Transplant for Combined Medial and Lateral Patellar Cartilage Lesions: The Osteochondral Wide Lesion (OWL) Technique

Symptomatic articular cartilage injuries are often seen in young active patients and athletes. Magnetic resonance imaging screening examinations have frequently identified such lesions in athletic patients. Patellofemoral chondral defects were previously identified as the most common knee cartilage lesion in high-level athletes. Chondral defects measuring 2 cm(2) or greater and complex cartilage defects involving bone loss are ideally replaced with fresh osteochondral allograft. We describe a technique indicated for patients with symptomatic and recurrent anterior knee pain associated with osteochondral patellar defects including the lateral and medial patellar facets. Patients who have undergone previous interventions, including membrane techniques, microfracture, or autologous chondral transplantation, without clinical benefit are also eligible to undergo osteochondral allograft transplantation for combined medial and lateral patellar cartilage lesions, that is, the osteochondral wide lesion (OWL) technique.