Osteochondral Allograft Transplantation for Osteochondritis Dissecans Lesions

Osteochondritis Dissecans (OCD) poses a complex treatment challenge, particularly in cases of unstable lesions or in patients who have failed conservative management. Osteochondral allograft transplantation (OCA) offers an effective solution for treating patients with large, multifocal, or complex OCD defects. This review provides an in-depth analysis of the current concepts, indications, and operative techniques for OCA in the treatment of OCD of the knee. OCA addresses both cartilage and underlying osseous injury, offering numerous advantages over other restorative techniques, including replication of native anatomy and lower graft failure rates. Postoperative outcomes for OCA reveal long-term graft durability, reduced pain, and improved functionality. Advancements in graft preparation, such as pulsed lavage, pressurized carbon dioxide, and orthobiologics, have further improved allograft viability and operative success. This review serves as an overview of the application of OCA as a versatile and effective treatment for OCD of the knee, highlighting recent advancements, graft durability, and satisfactory postoperative patient-reported outcomes.