Osteochondral Allograft Transplants for Large Trochlear Defects
Localized cartilage damage in the knee is a common cause pain and disability in younger populations. These cartilage injuries are common on the end of the femur but are also present on the back side of the patella and the groove the patella moves in called the trochlea. During a knee arthroscopy, cartilage injury is noted in the trochlear groove about 6-8% of the time. Large injuries in this area (typically over 4cm2) are hard to treat with regenerative treatment options, so oftentimes surgery is performed. The main surgical operation to address this injury is called an Osteochondral Allograft Transplant in which a cartilage graft from a cadaveric doner is inserted into the cartilage defect. The advantage of this procedure is that it does not use the patient’s own cartilage from somewhere, and the graft can be sized to match the exact defect, however one noted disadvantage is that it can cause a local immune reaction in the knee which causes the surgery to fail. The authors of this paper are experts in this surgery, and they published this paper as a step by step guide on how to perform the surgery, with the specific incisions, instruments, and measuring materials needed to make sure other surgeons can successfully recreate the procedure for their patients.