Osteochondral Autograft Transplantation for OCD: Techniques and Outcomes

Osteochondritis dissecans of the knee is a relatively common pathology presenting to sports knee surgeons with a variety of treatment options, such as drilling or drilling and internal fixation (if there is a viable fragment), or articular surface restoration techniques in the case of unsalvageable tissue. Articular surface restoration techniques include osteochondral autograft transplantation (OAT), osteochondral allograft transplantation (OCA), and autologous chondrocyte implantation (ACI). OAT is typically reserved for unsalvageable grade 3 and 4 articular cartilage lesions or revision cases. OAT involves the use of 1 or multiple osteochondral plug(s) harvested from the knee in a less-weightbearing regions such as the peripheral trochlea. Recent meta-analyses have demonstrated favorable outcomes after OAT procedures, with a large number of patients returning to sport and showing substantial improvements in functional outcomes. In addition, recent studies have compared the outcomes of OAT to other techniques in prospective randomized trials, demonstrating the favorability of this technique in the correct clinical scenario. This chapter focuses on the indications, surgical technique, and clinical outcomes of OAT in young patients with knee osteochondritis dissecans.