Meet Our SurgeonLonnie D. Davis, MD

  • Dr. Davis is like no other...his compassion and kindness is superior! Easy to talk to, explains everything, open to all questions and takes time with you.

    Bonnie - Fairfax VA

  • He did an excellent job on my surgery and follow up. All was as expected. He answers questions thoroughly but does not waste patient time.

    Irene - Reston VA

  • Given the extent of my injury and accident, Dr. Davis did a miraculous job getting me back to normal. He always kept me informed of what to keep an eye on, and how to address certain aspects of my new life adjusting to this injury.

    Jake - Reston VA

  • He was very knowledgeable and excellent at translating what the issue with my knee was from medical terminology into layman's terms. He was extremely thorough and with this being my third opinion on my knee, I immediately decided I would continue through the surgery process with Dr. Davis.

    Eva - Washington DC

  • He is fantastic! Very kind. Smart. Answered my questions. I know nothing. And he was so patient. Treated my son with wonderful kindness and dignity. Dr. Davis is a good man. Glad to have met him! Will definitely go to his office in the future if we have a need for it.

    Jodi - Reston VA

  • It was my first appointment with Dr. Davis and he impressed me with his concern for my wellbeing. He is extremely thorough, spends plenty of time with you and has an excellent bedside manner. I would recommend him to anyone with a sports related injury.

    Lauren - Alexandria VA

  • I'm pretty active and have seen Dr. Lonnie Davis for a number of sports-related injuries for the past few years. I've seen him for a torn ACL, stress fracture in the foot, rock-climbing hand and ankle injuries, etc. I was really impressed with how well my ACL surgery, care and recovery went. He's been great at diagnosing the problems and getting me back to sports.

    Jennie - Annandale VA

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Lonnie D Davis MD

Osteochondral Autograft

Introduction

Osteochondral autografting (OCG) is a surgery to repair damaged articular cartilage that lines the ends of bones in a joint. An osteochondral autograft is a piece of tissue taken from a healthy section of the joint and transplanted to replace the chondral defects in the joint. There are two techniques used in osteochondral autografting: mosaicplasty and osteochondral autograft transfer system (OATS).

Disease Overview

The articulating surfaces of all the joints in the body are lined by a soft tissue called articular cartilage, which cushions the ends of the bones. This allows easy gliding of the bones during movement of the joint. Injury and wear-and-tear can damage the cartilage, making it rough and sometimes exposing the underlying bone. This leads to painful rubbing of the bones of the joint and disability.

Indications

Osteochondral autografting is most commonly carried out to treat chondral defects of the knee. It is indicated for:

  • Small areas of damage, within 1 to 2cm2
  • Having symptoms of pain, swelling and catching
  • Localized, full-thickness injury
  • Patients under 50 years of age
  • Active patients with high physical demand

Surgical procedure

The implantation of osteochondral autograft is performed arthroscopically, under general or spinal anesthesia. Small incisions are made and an arthroscope, a narrow lighted tube with a camera, is inserted to give your surgeon a clear view of the surgical site.

First, the cartilage defect is prepared to receive the graft, by removing all the damaged tissue. Depending on the extent of damage or size of the lesion, your surgeon will decide on performing either mosaicplasty or OATS.

A portion of the non-weight bearing part of the joint is selected and exposed. Mosaicplasty involves the removal of multiple plugs of cartilage and underlying bone. Tunnels may be drilled to accept the individual graft plugs. The graft plugs are individually press-fit into the defect. Once all the grafts are implanted, the defect appears as a mosaic pattern.

The procedure for OATS is similar to mosaicplasty, except that in OATS, only one or two larger plugs are removed to fill the cartilage defect.

Once the implantation is completed, the incisions are closed and covered with a dressing.

Post-Operative Care

Following the surgery, a brace may be applied and you will be instructed to use crutches and limit bearing weight for the first 2 weeks. Your surgeon will prescribe medication to reduce pain. Early movement is encouraged, and you will be gradually introduced to physical therapy, which will be continued for 8 to 12 weeks. Your brace will be removed in about 6 to 8 weeks.

You may be able to return to your activities in 6 to 8 months.

Advantages & Disadvantages

As the graft is taken from your own body, there is a higher chance of successful donor graft incorporation and less risk of immune-mediated graft rejection.

The disadvantage of this procedure is the technical difficulty involved and limited donor site areas.

Risks and complications

As will all surgical procedures, the transplantation of osteochondral autografts may be associated with certain complications such as

  • Pain
  • Bleeding
  • Graft fracture
  • Avascular necrosis or tissue death in case of multiple graft harvesting
  • Loose bodies

Useful Links

  • The American Academy of Orthopaedic Surgeons
  • Medical Society of Virginia
  • American Orthopaedic Society for Sports Medicine
  • American Board of Orthopaedic Surgery
  • mid atlantic shoulder elbow society
  • mclean high school
  • STOP Sports Injuries