Abstract
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.