Except for the shoulder, osteochondral transplantation potentially allows for better functional outcome than curettage of OCD lesions. With mosaicplasty small core transplants from within the femoro-patellar joint can be used for autologous transplantation, while the OATS procedure is limited to the donor. sites abaxial to the femoral trochlea. The latter have only very thin cartilage and weak subchondral bone density.Donor site morbidity when using the stifle as the donor for other joints (shoulder, elbow, hock) might be frustrating, with septic arthritis and recurrent patellar luxation being the most significant complications. Allografts can be stored up to 8 weeks at 5°C, retaining > 75% of viable chondrocytes. No immunosuppressive treatment is needed when using allografts. With allografts orthotopic transplantation is possible, allowing for true anatomic reconstruction of the lesion, matching cartilage thickness, subchondral bone density and surface curvature perfectly. Correct orthogonal transplantation is the most challenging technical aspect when performing osteochondral transplantation. Using templates significantly increases surface congruence.
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