Lateral Femoral Condyle Osteochondral Allograft and Concomitant Lateral Opening-Wedge Distal Femoral Osteotomy in the Setting of Failed Osteochondritis Dissecans Fixation.

Osteochondritis dissecans (OCD) is a subchondral bone and articular cartilage abnormality that can lead to detachment of a bone fragment and eventually osteoarthritis. Juvenile OCD typically presents in male patients, with the most common presenting symptom being pain with weight-bearing. When conservative measures are not effective, OCDs are treated surgically with subchondral drilling, fixation, or autologous chondrocyte implantation, depending on the severity of the lesion and whether it has detached. Fragment fixation of the bone fragment may be attempted for high-grade OCD with subchondral bone to try and restore the native cartilage. When fixation of an unstable OCD lesion is unsuccessful, osteochondral allograft transplantation and an offloading osteotomy may be considered. This Technical Note describes a lateral opening-wedge distal femoral osteotomy and osteochondral allograft transplantation for a failed OCD fixation of the lateral femoral condyle.