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Fresh Mega Patellar Osteochondral Allograft Transplantation for Isolated Patellar Chondral Injuries

March 01, 2020

Contributors: Thomas M DeBerardino, MD, FAAOS; Alexander Bradley Kreines, DO

Chondral lesions of the patellofemoral joint are a common finding in patients undergoing routine arthroscopy, being observed in more than one-third of patients. Multiple treatment options, including microfracture, autologous chondrocyte implantation/matrix-induced autologous chondrocyte implantation, particulated juvenile articular cartilage allograft transplantation, and osteochondral autograft transplantation and allograft transplantation, are available for the management of full-thickness chondral defects. Because of the delicate nature of most of these procedures, some studies have reported better outcomes with routine concomitant unloading osteotomies. The rationale for fresh mega patellar osteochondral allograft transplantation is that it creates a structural bioplasty of the patella that is able to withstand the high forces across the patellofemoral joint, potentially decreasing the need for routine unloading procedures. Compared with cartilage procedures in the trochlea and femoral condyles, inferior outcomes scores are consistently associated with cartilage procedures in the patella, and fewer studies are available on cartilage procedures in the patella. This video demonstrates our technique of fresh mega patellar osteochondral allograft transplantation in a 32-year-old woman with a grade IV isolated patellar chondral defect and evaluates the short-term results of our case series.

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