This technique involves taking small amounts of bone and cartilage from low-weight-bearing parts of the femur (thigh bone) within the knee and transferring them to the higher-weight-bearing area of injury.

This grafting can be performed through arthroscopy, open technique or mini-open technique through a small incision.

Often, arthroscopy is used for diagnosis, and then a mini-open approach is used to complete the procedure. The size and shape of the defect is determined, and it is prepared using the appropriate equipment. The area of the femur from which the grafting material will be taken will be selected based on the size and shape of the injured area. A harvesting chisel is used to remove the tissue, which is then inserted into the prepared area.

One of the main advantages of this procedure is that it results in mature, healthy cartilage at the defect site. In addition, it can successfully be used to correct bone loss or an abnormality. However, it can negatively affect the area from which material is harvested, and the amount of material available can be limited. Therefore, this approach is best for correcting small defects.

Rehabilitation

Post-operative rehabilitation consists of toe-touch weight-bearing for 4 to 8 weeks, depending on the extent of grafting performed. Early, progressive motion is encouraged with special equipment, and a return to athletic activity is delayed for 4 to 6 months.

Outcome

Most studies report good-to-excellent results in up to 90 percent of patients treated for specific types of defects. Smaller defects tend to do better than larger defects.