Table 3.

Advantages and Limitations

Advantages

The treatment is biological.

The procedure is indicated in young subjects with extensive cartilage or osteochondral lesions in the patella and trochlea (kissing lesions) with Dejour type C or D trochlear dysplasia that cannot be treated with other, less aggressive techniques.

Good results are achieved when performed with a surgical technique that follows a few standard steps to maintain the long-term viability of the graft.

Fresh osteochondral allografts are biomechanically and histologically comparable with autografts and retain viable chondrocytes.

Implantation of a patellofemoral arthroplasty is prevented.

Limitations

The use of fresh allografts carries considerable logistic limitations, and this material is not easily available worldwide.

The main exclusion criteria are advanced osteoarthritis of other compartments of the knee and general conditions such as infections, tumors, locally aggressive rheumatic disease, diabetes, and vasculitis.

Relative contraindications are BMI >30 and age >50 yr. Smoking must be stopped 30 d before surgery and abstained from for at least 6 mo after the operation.

Only patients who have severe chronic pain that limits their daily activities and see no improvement with rehabilitative treatment are candidates for this treatment.

The technique is not intended for patients seeking to return to demanding pivoting activities.

BMI, body mass index.