Harvest site


Option 1

- lateral and medial aspect femoral trochlea


Option 2

- intercondylar notch


Mosaicplasty Harvest Site


Option 3

- allograft

- can take larger grafts without donor site risk




Many options

- 4.5 mm most common

- want to minimise donor site pathology


Technique Mosaicplasty Type 3 OCD


Mosaicplasty equipment


Lateral Femoral OCDLateral Femoral OCD Superior Displacement



- insert 4.5 mm chisel

- hammer to appropriate depth / 20 mm

- twist handle to remove


Mosaicplasty Harvest ChiselMosaic Harvest Site 2Mosaicplasty Harvest Site 2


Mosaicplasty PlugsMosaicplasty Plugs 2


Mosaicplasty Harvest Site MRI


Debride base of OCD and reduce


Femoral OCD Base DebridementFemoral OCD ReductionFemoral OCD Reduction 2


Drill site of mosaicplasty with 4.5 mm drill

- overdrill 2 - 4 mm

- do not want to leave plug proud

- impossible to sink further or remove


Mosaicplasty 4.5 mm drilMosaicplasty 4.5 mm drill 2


Insert dilator


Insertion device

- place over drill hole

- impact with hammer to seat in cartilage

- insert plug

- use tap to insert plug

- best to countersink 1 - 2 mm


Mosaicplasty Plug ImpactionMosaicplasty Cartilage Cap ProudMosaicplasty Impaction


Mosaicplasty Plug in situ




Mosaciplasty second plugMosaicplasty Plugs in OCD


Post op


Often most stable in extension

- splint in extension 2 weeks

- gentle increased ROM in brace over next 4 weeks

- strict NWB 6/52


Allow weight bearing at 6/52

- no sports for 6/12

- MRI cartilage sequences at 3 and 6 months to assess cartilage healing


Knee OCD Mosaicplasty PreKnee OCD Mosaicplasty 9 months post


Mosaicplasty Healed OCD LateralMosaicplasty Healed MRI AP