Mosaicplasty Using Grafts From the Upper Tibiofibular Joint

Autologous mosaicplasty has been widely used for the treatment of focal, full-thickness, articular cartilage lesions of the knee and ankle joints. Commonly, the autografts are harvested from non-weight-bearing areas of the knee joint, leading to associated donor-site morbidity and representing a considerable disadvantage. This Technical Note presents a mosaicplasty procedure for harvesting autologous osteochondral plugs from the upper tibiofibular joint to repair articular cartilage defects. With this technique, it is possible to achieve low or no risk of donor-site morbidity, being therefore a safe and favorable option to treat large cartilage defects. Because of its minimal size-related restrictions, it enables harvesting larger plugs (filling an area up to 5 cm²) without any additional iatrogenic complications. Hence, mosaicplasty using the upper tibiofibular joint autografts can overcome many of the reported complications associated with osteochondral autograft harvesting. Thus, the upper tibiofibular joint articular surface should be considered as a safe and reliable autograft source for harvesting osteochondral plugs.