Fresh Osteochondral Allograft Transplantation as a Salvage Procedure Following Failed Fixation of Osteochondritis Dissecans of the Lateral Femoral Condyle: A Case Report.
José Eduardo Miranda-Mayén, César Alejandro Jiménez-Aroche, Martha Acosta-Pavón et al.
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Case in brief
A 19-year-old competitive athlete developed recurrent left-knee pain and mechanical locking after fixation of osteochondritis dissecans of the lateral femoral condyle. Imaging showed failed fixation with retained hardware, loose bodies, and a 25×12 mm osteochondral defect. After removal of the failed fixation and loose bodies, she underwent fresh, size-matched osteochondral allograft transplantation using a press-fit technique. At 24 months, she had functional range of motion and quadriceps strength, no mechanical symptoms, and had returned to high-level athletic activity. MRI showed satisfactory graft incorporation without graft-related complications; her IKDC score was 93/100 and Tegner score was 7, versus 8 before injury.
What made this case unusual
The allograft was used as a joint-preserving salvage procedure after failed fixation of a lateral femoral condyle OCD lesion, with retained hardware and loose bodies accompanying the resulting defect.
Diagnostic / clinical pearl
Recurrent pain and locking after OCD fragment fixation can reflect fixation failure with loose bodies and a substantial osteochondral defect; imaging can define these findings and guide salvage planning.
Why it matters
This case documents satisfactory incorporation and return to high-level activity at 24 months after fresh OCA in a carefully selected young patient, while the report notes that evidence for this salvage use remains limited.