Anatomic Matching and Contouring of Femoral Trochlear Osteochondral Allografts

Performing a fresh trochlear osteochondral allograft can be challenging, given the complex anatomy of the trochlea. The recipient's anatomy can be difficult to match with the currently used allograft matching criteria, often leading to a nonanatomic articular surface. There is currently little information available to optimize graft congruence with the recipient patient for trochlear osteochondral allograft procedures. We describe a method for optimal trochlear graft matching preoperatively by using multiple measurements, including the trochlear width and sulcus angle at the proximal and distal aspects of the patient's trochlea. Additionally, we describe a method for allograft preparation and insertion that relies on more points of reference to create a highly congruent articular surface.