Osteochondral Autograft Transplantation Surgery for Metacarpal Head Defects

J Hand Surg Am. 2016 Mar;41(3):457-63. doi: 10.1016/j.jhsa.2015.12.021. Epub 2016 Jan 21.


Post-traumatic osteonecrosis of the metacarpal head is a challenging problem, particularly in younger patients in whom arthroplasty may not be a durable option. Although several osteochondral reconstructive options have been proposed, some are associated with considerable donor site morbidity and/or require the use of internal fixation. We present an application of osteochondral autograft transplantation surgery as a treatment option for focal metacarpal head lesions. An osteochondral plug from the non-weight-bearing articular surface of the knee is transferred and press-fit to resurface a focal metacarpal head defect. The technical pearls and pitfalls are reviewed, and an illustrative case is presented.

Keywords: Dieterich disease; OATS; Osteochondral autograft; avascular necrosis; metacarpal head.

Publication types

  • Review

MeSH terms

  • Bone Transplantation / methods*
  • Femur / transplantation*
  • Humans
  • Metacarpal Bones / pathology
  • Metacarpal Bones / surgery*
  • Osteonecrosis / pathology
  • Osteonecrosis / surgery*
  • Transplantation, Autologous