The use of fresh allografts in osteochondrosis dissecans of the lateral femoral condyle.

OBJECTIVE

Reconstruction of joint surface by using allografts to fill extensive bone-cartilage defects.

INDICATIONS: Bone-cartilage defects ranging from a diagonal length of at least 3 cm and a depth of minimum 1 cm to maximum the entire lateral femoral condyle, e. g., following trauma, in the case of osteochondrosis dissecans, or following the resection of benign tumors.

CONTRAINDICATIONS: Arthrosis. Minor or superficial cartilage defects. Bipolar defects.

SURGICAL TECHNIQUE: The transplant bed is reamed precisely into the recipient's knee, the donor knee is opened, the block required for transplantation is measured, prepared and press-fit inserted. A straight leg axis is required for a good surgical result.

POSTOPERATIVE MANAGEMENT: No weight bearing on the operated leg, two underarm crutches for 10 weeks, then partial weight bearing and further increase in weight bearing depending on postoperative allograft healing. CT follow-ups to assess postoperative healing of the transplant after 3 and after 8-12 months. Sporting activities that put pressure on the knee joint should not be undertaken until at least 1 year after surgery; cycling and swimming-depending on the CT-from the 6th postoperative month onward.

RESULTS

Three male patients aged 21 (n = 2) and 28 (n = 1) were operated on for osteochondrosis dissecans of the lateral femoral condyle and observed for an average of 26 months. Postoperative healing of the transplanted tissue was confirmed in all patients by means of CT. For two of them, the vitality of the transplant was confirmed by means of MRT and contrast agents, and good postoperative healing of the transplant was also represented arthroscopically. All patients were subjectively satisfied, without complaints, and had improved range of motion in the operated knee.