Osteochondral autograft plug transfer: achieving perpendicularity

Although osteochondral autograft plug transfer is a common clinical procedure, few authors have addressed the outcomes or how variations and surgical technique can influence results. Variations in arthroscopic versus open harvesting techniques, as well as intercondylar notch versus lateral trochlear ridge harvest locations, influence the ability to obtain the most perpendicular osteochondral grafts. Eight fresh-frozen cadaveric knees were studied. Four plugs were harvested from each knee, two from the superior lateral intercondylar notch area and two from the superior lateral trochlear ridge area. Plugs harvested from the lateral trochlear ridge (86.9 degrees) were statistically more perpendicular than the plugs harvested from the intercondylar notch (83.3 degrees) (P=.02). No statistically significant difference was noted between the open (86.4 degrees) and arthroscopic (83.8 degrees) harvesting techniques (P=.11).