A Novel Posterior Arthrotomy Approach for the Treatment of a Large Osteochondral Defect of the Posterior Aspect of the Lateral Femoral Condyle of the Knee: A Case Report and Technical Note.

Symptomatic osteochondral lesions of the knee pose a considerable treatment challenge to orthopaedic surgeons, particularly when they occur in young active patients. The prognosis of osteochondral defects is worse when the defect is sizable, when it is located in a weight-bearing portion of the knee, and when there is considerable bone loss. Hyaline cartilage is unable to heal spontaneously because of its unique structure and distinctive properties. As a result, many chondral resurfacing techniques have been employed for the treatment of osteochondral injuries. Osteochondral autograft transplantation is successful in covering relatively small defects, but has considerable technical limitations and has been associated with increased donor-site morbidity for larger defects (>2 · 2 cm). Therefore, allografts have been proposed for themanagement of larger defects. One of the critical issues regarding surgical technique is the perpendicular placement of the bone plug. Incongruency, resulting from proud graft placement, can give rise to a ‘‘kissing lesion’’ on the contralateral surface. We report the case of a patient with a large osteochondral lesion of the posterior aspect of the lateral femoral condyle of