Hunter 1743

... once violated ... articular

cartilage defects a trouble
something ... they dont heal !!!

Chondral lesion on the

patellofemoral joint is
the main problem
in the sports traumatology

BASIC PROBLEMS OF THE

osteochondral autologous
transplantationin the patellofemoral
joint

Donor sites should be relatively nonweight-bearing

surfaces which are limited in the knee joint

Harvesting too big plugs, struggle the risk of

incongruency at the recipient site

Increased patellofemoral pressure/patellar tiltsubluxation

SOLUTION

Harvesting multiple smaller size plugs

Implantation in Mosaicform to recipient site

Lateral release, Fulkerson anteromedialization

osteotomy

AIM
Reconstruction of the
joint surface

INDICATIONS
Lesion
type
Localization
Size

Localized / Complete
Central faset

1 3cm2 IDEAL

TECHNIQUE

DONOR AREA
Both sites of the
femoral trochlear
borders

DONOR AREA

>5 mm from
peripheary

>6mm gap
between grefts

DONOR AREA

Do not harvest any plug from tibiafemoral site

DONOR AREA

Control each harvested plug for:

Integrity
Fracture
Obliquity
Depth

RECIPIENT AREA

Filling the defects as much as

with Hyaline cartilage can
reduce Fibrocartilage formation

OATS

PATELLAR DRILLING
SUBCHONDRAL BONE S TOO HARD TO
PREPARE WTH OATS RECIPIENT
INSTRUMENTS

TRICKS
Take care the joint
congruensy while
transfering plugs

Joint surface reconstruction is a challenge

OAT + Fulkerson osteotomy

CASE-1

CASE-1

CASE-2

CASE-2

CASE-2

CASE-3

CASE-3

CASE-4

CASE-5
BB

CASE-6

CASE-7

CASE-7

CONCLUSION
Donor site morbidity is a problem. Borders of the PF joint
are accepted as relatively nonweight-bearing surfaces but
we dont have any idea for long term
Short term results of OAT are promising,
BUT we dont know whether these transplanted hyaline
cartilage grafts prevent arthrosis for long term or not ???