Osteochondral Allograft Transplantation of the Lateral Femoral Condyle and Distal Femoral Osteotomy in the Setting of Failed Osteochondritis Dissecans Fixation

Hasani W Swindell; Benjamin Kerzner; Obianuju A Obioha; Luc M Fortier; Zeeshan A Khan; Suhas P Dasari; Enzo S Mameri; Pablo E Gelber; Jorge Chahla

doi:10.1016/j.eats.2022.03.014

Osteochondral Allograft Transplantation of the Lateral Femoral Condyle and Distal Femoral Osteotomy in the Setting of Failed Osteochondritis Dissecans Fixation

Arthrosc Tech. 2022 Jun 21;11(7):e1301-e1310. doi: 10.1016/j.eats.2022.03.014. eCollection 2022 Jul.

Authors

Hasani W Swindell^{1

2}, Benjamin Kerzner^{1

2}, Obianuju A Obioha^{1

2}, Luc M Fortier^{1

2}, Zeeshan A Khan^{1

2}, Suhas P Dasari^{1

2}, Enzo S Mameri^{1

2}, Pablo E Gelber^{3

4}, Jorge Chahla^{1

2}

Affiliations

¹ Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A.
² Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
³ Department of Orthopaedic Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Catalunya, Spain.
⁴ Institut Català de Traumatologia i Medicina de l'Esport, Hospital Universitari Dexeus, Universitat Autonoma de Barcelona, Barcelona, Spain.

Abstract

Osteochondritis dissecans (OCD) is a pathologic condition, most commonly affecting the knee joint in adolescents and young adults, although pathology can also be found at the elbow and ankle. Lesions to the medial femoral condyle are classically associated with varus alignment, while lesions to the lateral femoral condyle are seen in patients with valgus malalignment. Common risk factors for failed fixation of OCD lesions include unstable lesions to the lateral femoral condyle, screw breakage, older age, and closed physes. The purpose of this technical note is to describe the preoperative planning and step-by-step surgical approach for treatment of failed fixation of an OCD lesion of the posterior aspect of the lateral femoral condyle in young, active patients using an osteochondral allograft, a lateral opening wedge distal femoral osteotomy to correct malalignment, and a tibial tubercle osteotomy to facilitate access to the lesion.