Osteochondral Allograft Transplantation for a Large Focal Osteochondral Defect of the Lateral Femoral Condyle: Technical Note and Case Report.

Focal osteochondral defects in young individuals pose a significant challenge, often leading to chronic knee pain, functional limitations, and early onset of osteoarthritis if untreated. Osteochondral allograft (OCA) transplantation can offer a promising solution for large osteochondral defects. The aim of the study is to present a surgical approach for managing a large focal osteochondral defect in the lateral femoral condyle of a young, active patient through OCA transplantation. A 24-year-old male presented with atraumatic knee effusion, progressive pain, and impaired physical function. Imaging revealed a large osteochondral lesion in the lateral femoral condyle. After thorough pre-operative planning, including the creation of a 3D-printed model of the distal femur, the patient underwent lateral femoral condyle allograft transplantation. The procedure involved excision of the lesion, preparation of a size-matched OCA, and fixation with cannulated screws. Bone marrow aspirate concentrate was applied to enhance graft integration. Post-operative management included a progressive rehabilitation protocol with gradual knee flexion and weight-bearing. At 6 months postoperatively, the patient demonstrated significant clinical improvement with a Lysholm Knee Score of 89 and an International Knee Documentation Committee score of 87.4%. Follow-up imaging confirmed graft integrity and articular congruency. OCA transplantation is an effective surgical option for large osteochondral defects in the knee, providing satisfactory functional and clinical outcomes. This case highlights the importance of meticulous pre-operative planning, precise surgical technique, and structured post-operative rehabilitation in achieving successful results.