Utilizing Mosaicplasty for Cartilage Resurfacing

Osteochondral defects are a significant clinical challenge for orthopaedic surgeons. Patients often experience swelling, clicking, pain, and at times, a feeling of instability. Although some low-demand patients can be adequately managed with nonoperative treatments, active, young patients or older patients with a higher activity level often benefit from surgical intervention for symptomatic lesions. Several surgical therapies exist to treat symptomatic cartilage injuries. Osteochondral autograft transplantation, or mosaicplasty, is an effective treatment for cartilage lesions ranging from 1-5 cm2. Healthy osteochondral plugs are harvested from the non–weight-bearing areas of the superolateral or superomedial femoral condyles and used to fill the cartilage defect. This provides replacement of congruent hyaline cartilage into a focal defect without the need for cartilage growth, allograft, or synthetic tissue. The procedure is technically demanding, but in the appropriate patient population, several series have had good to excellent results in the medium to long term.