Isolated Osteochondral Autograft Mosaicplasty for In Situ Fixation of Unstable Osteochondritis Dissecans in Skeletally Mature Patients

Osteochondritis dissecans of the adult knee may result in unstable lesions that cause pain and mechanical symptoms. These often require surgery due to the failure of conservative management. Surgical techniques aim to retain the fragment where possible. Mosaicplasty for in situ fixation provides mechanical stability and a biological stimulus without the need for additional hardware. This all-arthroscopic technique uses osteochondral autograft plugs harvested from a nonweightbearing part of the knee to bridge through the lesion into the subchondral bone. Graft diameter and length can be tailored to the lesion and patient. Postoperatively, patients commence early range-of-motion exercises and follow a graduated weightbearing protocol.