Transplantation of donor cartilage-bone graft to repair focal joint defects
Osteochondral allograft transplantation replaces a focal area of damaged cartilage and its underlying bone with a matched piece of fresh donor cartilage-bone tissue, sized and shaped to fit the defect. It is used mainly for larger or deeper chondral and osteochondral lesions in the knee where the patient's own tissue cannot adequately fill or heal the defect.
For clinicians managing rehab after knee surgery, knowing a patient has had OCA rather than microfracture or an autograft procedure changes expectations around graft incorporation, weight-bearing progression, and timelines to return to sport. It signals a more extensive lesion and a longer, more cautious rehabilitation course, and it shapes conversations with the patient about realistic recovery and activity goals.
In practice, OCA is applied surgically by press-fitting or fixing the donor osteochondral plug into the prepared defect, with post-operative management guided by protected weight-bearing and staged loading to allow bony and cartilage integration. Clinicians monitor progress through clinical assessment of pain, effusion and range of motion, alongside surgeon-directed imaging to check graft incorporation before progressing rehabilitation phases.
Graft availability, cost, and the need for size-matched fresh donor tissue limit how widely OCA can be used, and outcomes depend heavily on appropriate patient selection — it is not a first-line option for smaller or less severe lesions. Rehabilitation timelines are typically longer than after microfracture, and premature return to loading or sport before adequate graft incorporation is a recognised risk of over-eager progression.
This guide was auto-drafted and is pending editorial review.