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From the American Academy of Orthopaedic Surgeons

New Techniques to Restore Articular Cartilage

Autologous Osteochondral Transplantation

by Nicholas Sgaglione, MD; Jordan Kerker, MD

Osteochondral autograft transplantation is a viable treatment option for symptomatic high-grade articular cartilage lesions of the distal femur in young, active patients. The advantages of this technique include graft availability, the absence of disease transmission, and the low cost of a single surgical procedure. Disadvantages include graft availability and donor-site morbidity. Osteochondral autograft transplantation is a technically demanding procedure, and particular attention must be given to choosing the location of the donor site and harvesting appropriately sized osteochondral grafts. In addition, the method of graft harvest and delivery affects both chondrocyte viability and recipient graft stability. The future of articular cartilage restoration is promising. New advances in technology, bioengineering, and gene-modified tissue engineering will provide surgeons the tools to more accurately restore articular defects to normal hyaline cartilage, thus allowing patients to maintain a high level of activity.

Keywords: osteochondral pathology, articular cartilage injury, articular cartilage lesions, hyaline cartilage defects, osteochondral grafts, OATS, osteoarticular transfer surgery, osteoarticular allograft transplantation, osteochondral autograft transplantation, mosaicplasty, chondral osseous replacement, COR, autologous chondrocyte implantation, ACI

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