Use of large osteochondral allografts in reconstruction of traumatic uncontained distal femoral defects

Large osteoarticular injuries with subchondral bone loss involving the knee in young active patients often result in significant morbidity and loss of normal joint function. A review of the current literature reveals that multiple surgical management options are currently employed, however there is no consensus on standard of care. Osteochondral allografting provides an attractive alternative treatment option for the repair of large articular defects of the knee. In this article we present the case of a young male who suffered traumatic intraarticular bone loss secondary to a grade IIIA distal femoral fracture and subsequently underwent reconstruction of his medial femoral condyle using a fresh-frozen osteochondral allograft. We present the radiographic and functional outcome of this patient at two years post-operative. The range of motion of the knee was 0–130° and the patient's post-operative functional outcome was evaluated using the Knee injury and Osteoarthritis Outcome Score (KOOS), which was 76%. While further research is required, the results of our case study concur with the current body of literature supporting the use of fresh-frozen osteochondral allograft as a reconstructive option for treating large traumatic intraarticular lesions involving the distal femur.