Medial malleolar osteotomy with mosaicplasty (Osteochondral autograft transfer)

Wirat Kongcharoensombat, M.D., Ph.D.
Institute of Orthopedic
Lerdsin Hospital

AOSMAK volume 2 (2022)

Archives of Orthopedic Sports Medicine and Arthroscopy Knowledge (AOSMAK) is an open-access peer-reviewed journal of Thai Orthopaedic Society for Sports Medicine (TOSSM)

Medial malleolar osteotomy with mosaicplasty (Osteochondral autograft transfer)
We set the patient in supine position.
Arthroscopic examination was performed , and unstable chondral lesion( 2 square centimeter) was identified.
Regarding to inadequate exposure, medial malleolar osteotomy was performed.
Vertical anteromedial skin incision was done at the left ankle.
Two small cancellous screws were pre drilled and tapped in perpendicular to osteotomy cutting.

Medial malleolar osteotomy was gently performed with minisaw and thin osteotome until cartilage lesion was seen.
Cartilage lesion base was cleaned and chondral fragment ( cm)was removed.
Harvest site: two osteochondral autograft (4.5mm; appropriate to curved dome of talus)were harvested from lateral suprachondylar ridge of the same knee.

Recipient site: mosaicplasty harvest was created with drill bit (4.5mm), then dilatation was done.

Osteochondral plug was insert to the recipient hole.
Tam was gently performed until chondral surface quite was equal to the shoulder level of recipient cartilage.
Osteotomy site was fixed with two small cancellous screws.

*I have no conflict of interest to disclose.