الفهرس 
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Abstract
Focal chondral defects of the knee are relatively common. These lesions can result from trauma, Osteochondritis dissecans (OCD). These focal articular cartilage lesions may become symptomatic, when they occur in young active persons, they will be rendered incapacitated by symptoms like exertional pain, swelling, mechanical symptoms as catching, locking, and may be giving way. These lesions have limited ability to heal and may progress to osteoarthritis. This presents an especially difficult clinical problem in young, high-demand patients.
In 1743, Hunter stated that “articular cartilage once destroyed, never repaired”. For more than 2 centuries, this statement remained somehow true, There are many treatment options for focal chondral defects, each having advantages and disadvantages, Traditional surgical methods such as debridement and marrow stimulation techniques as drilling, abrasion arthroplasty and microfracture, although technically simple, they do not restore normal hyaline cartilage and have a short-term success rate.
Instead, these methods predominantly promote a fibrocartilage healing response, which is biomechanically inferior to true hyaline cartilage, with predominance of type 1 collagen. as it has been proven that optimal outcome of the cartilage repair procedures is associated with restoration of hyaline or hyaline-like articular cartilages as well as the subchondral bone.
Autologous osteochondral grafting (OATS) is potentially an excellent method of biological resurfacing of focal chondral and osteochondral defects of the weight bearing surface of the knee, Osteochondral autogenous transfer refers to the transfer of a plug of osteochondral tissue with overlying normal intact articular cartilage with viable chondrocytes and underlying attached subchondral bone into an articular cartilage defect ,moreover the incorporation of the osseous part of the osteochondral plug
Summary
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follows the principles of bone to bone healing. the method is not laboratory dependent, is of low cost, involves only a one stage procedure, and carries no risk of disease transmission or immunologically mediated damage to the graft.
Patients & methods; This prospective clinical Study included 30 patients, had focal chondral or osteochondral defects of the weight bearing articular surface of the knee joint, most (90%) of the studied patients had medial femoral condyle (MFC) while, 10% of them had lateral femoral condyle (LFC). Also, 60% of the studied patients had right side and 40% had left side. The mean ± SD defect size was 2.55±0.48 cm2 with ranged 1.2 -3 cm2. They were treated with osteochondral autografting with a at least follow up period of 6 months, during that period, all of the cases were followed up clinically, radiologically. The clinical outcome of all patients was analyzed using the Cartilage Standard Evaluation Form as proposed by the International Cartilage Repair Society (ICRS). This form considers both subjective symptoms which were analyzed, and scored according to the 2000 subjective international knee documentation committee (IKDC) evaluation form as well as, objective assessment, and grading of the clinical findings according to the Objective IKDC 2000 evaluation form.
The mean age of our patients was of 28.93±6.70 years, most of them were males (27), most of the cases were due to osteochondritis dissecans 24 cases (80%). In 27 cases (90%), the lesion was located in the medial femoral condyle. while in the remaining 3cases (10%), the lesion was located in the lateral femoral condyle. The mean duration of symptoms was 12.96±2. 74 months.
All patient had Focal, (grade III or IV) uni-polar lesions on the weight-bearing surface of the femoral condyles that are between 1 and 3 cm2 in size, with documented minimal to absent degenerative changes in the surrounding articular cartilage (ICRS Grade II or less), and normal knee biomechanics, alignment and stability
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All the patients had preoperative x ray, MRI, and preoperative arthroscopy mainly to assess the size and depth of the lesion, as well as the overall status of the articular cartilage especially that at the donor sites. And for Retrieval and extraction of loose bodies that may be responsible for the mechanical symptoms.