Mosaic arthroplasty is a promising repair strategy for managing large subchondral bone lesions. This project focused on identifying appropriate donor sites for reconstructing the MFC, augmentation with bioresrobable bone cement, and graft stability in the early post-operative period, all in an effort to optimize this surgical technique.; Donor sites located on the central lateral trochlea provide the closest match available on the distal femoral surface with regards to subchondral bone properties and cartilage thickness. Configurations of multiple osteochondral grafts in cement did not provide comparable initial fixation strength to that of intact bone. The inclusion of cement does improve graft stability, fills interstitial spaces and provides a scaffold for bone remodeling. A 6-DOF joint simulator was developed to examine construct stability under loads of physiological magnitude. Initial testing confirms that graft placement alters joint contact pressure distribution under static loads and that gel retention can be studied under dynamic conditions.
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