A recent article published by the American Orthopaedic Society for Sports Medicine (AOSSM) highlights promising outcomes for patients undergoing bipolar osteochondral allograft (OCA) transplantation to address chondral defects involving both the patella and trochlea. Authored by José Vega, MD, Zachary Oppenheim, BS, and Adam Yanke, MD, PhD, the report underscores that when patellar instability underlies these defects, OCA transplantation can be safely and effectively performed alongside medial patellofemoral ligament reconstruction (MPFLR) and tibial tubercle osteotomy (TTO).
The authors describe a case involving a young, active patient with recurrent patellar instability and advanced bipolar cartilage damage. Through a combined surgical approach—OCA transplantation, MPFL reconstruction using a hamstring allograft, and anteromedializing TTO—the team was able to address both cartilage loss and the underlying biomechanical contributors to instability. The technical description emphasizes precision in graft sizing and placement, along with careful sequencing of each reconstructive step to optimize outcomes.
Clinical results and literature review findings support this approach: bipolar patellofemoral OCA transplantation has been shown to significantly improve patient-reported outcomes and demonstrates strong graft survival for at least a decade. Importantly, correcting the anatomic factors contributing to maltracking or instability—through MPFLR and TTO—appears to enhance long-term success. As the authors note, this combined procedure offers a durable and comprehensive option for appropriately selected patients, particularly younger individuals whose cartilage defects stem from chronic instability rather than generalized degeneration.