Table 2.

Advantages and Limitations

Advantages

-Constellation of procedures can be performed in a single-stage fashion, resulting in decreased burden to the patient and health care system for multiple surgical procedures

-Both valgus deformity and large defects are addressed; they would not be addressed with an internal fixation of the fragment

-Realignment of the mechanical axis with a distal femoral osteotomy (DFO) results in improved weight distribution along the tibiofemoral joint, decreasing risk for early progressive arthritis

Limitations

-Allografts may not be available in certain resource-limited locations and thus not operative options for large defects to the femoral condyle

-Patients are required to be non-weightbearing for 10 to 12 weeks, ultimately limiting activity and function during the perioperative period

-Large allografts require substantial preoperative planning for allograft acquisition

-Osteochondral allografts have a small potential for disease transmission and host immunologic response, resulting in rejection of the graft

-There is potential risk of damage to the anterior or posterior horn of the lateral meniscus during the osteochondral allograft transplantation of the lateral femoral condyle