Autograft Osteochondral Transfer

The treatment of osteochondral injuries of the knee continues to challenge orthopedic surgeons. One option for treatment is autograft osteochondral transfer (AOT), which involves the transfer of plugs of intact cartilage and subchondral bone from an area of low load bearing to a full-thickness lesion in another area of the knee. The procedure has gained popularity because of its low cost, durable repair tissue, single-stage technique, and good results in outcome studies. Second-look arthroscopy has shown good healing at the graft site, smooth gliding surfaces, and histologic evidence of hyaline cartilage and viable chondrocytes. Donor-site morbidity is the most frequently reported complication, although its occurrence is rare in most follow-up studies. Although donor tissue is readily accessible, the limited amount available for harvest restricts the defect size that can be addressed to 1 to 4 cm2. AOT has performed well in young athletes and compares favorably with other treatments for osteochondral lesions. When performed correctly in the right patient, AOT provides an excellent option for the treatment of full-thickness osteochondral defects with durable and predictable results with respect to pain relief and return to activity.