Knee · Cartilage
Osteochondral allograft — patellofemoral
Cartilage and Bone Defect of the Kneecap (Patella) or Trochlear Groove
The condition
Articular cartilage covers the back of the kneecap (patella) and the groove it glides in (trochlea). Defects of both cartilage and bone—from injury, kneecap dislocation, or OCD—heal poorly and cause pain at the front of the knee with stairs, squatting, and sitting, plus swelling and grinding.
The surgery
An osteochondral allograft replaces the damaged area with matching donor cartilage and bone, press-fit through an open incision (typically outpatient). Depending on your kneecap's alignment and stability, your surgeon may also shift the bump on the shin bone (TTO) or rebuild the MPFL ligament. The final plan is determined during surgery.
Recovery at a glance
- Weight-bearing
- Without a tibial tubercle osteotomy (TTO): Full weight with crutches and a brace locked straight for 6 weeks. With a tibial tubercle osteotomy (TTO): No weight on leg for 4 weeks, then half weight; full weight after the 6-week x-rays.
- Motion
- Gentle bending out of the brace starts right away: 90° for 4 weeks, 120° by 6 weeks. The brace comes off at 6–8 weeks. If you have a TTO: bending and straightening may be limited initially. PT will teach you what you can and cannot do.
- Daily life
- Desk work often within 2 weeks. Deep squats and lunges are avoided for months. No driving while taking narcotic pain medication.
- Running
- No impact until 6 months, and then only after clearance.
- Sports
- Cutting and contact sports typically 8–12 months, after strength and hop testing.
A general guide. Your restrictions and timeline may change based on what is found and done at surgery.
Risks & benefits
Benefits: Most patients have less pain at the front of the knee and better function. Risks are uncommon and include infection, blood clots, the graft not healing or wearing, ongoing front-of-knee pain, a very small risk of disease transmission from donor tissue, injury to nearby structures (such as nerves, blood vessels, or cartilage), stiffness, persistent pain, and the need for further surgery. These will be reviewed with you in detail before surgery.
Patient Surgical Information
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Before & after every surgery