CPT® Code 28446

An open osteochondral autograft is a surgical procedure that involves the transplantation of bone and cartilage tissue from one area of the patient's body to the talus, which is a bone in the ankle. This procedure is typically performed to address conditions such as osteochondritis dissecans, a disorder characterized by the separation of a fragment of bone and cartilage from the underlying bone, leading to pain and dysfunction in the ankle joint. The procedure begins with the creation of an incision over the affected area of the ankle, allowing the surgeon to access the joint capsule through an arthrotomy. In some cases, an osteotomy of the medial or lateral malleolus may be necessary to provide adequate access to the lesion on the talus. The damaged tissue is carefully debrided to prepare the site for the graft. The osteochondral autograft is harvested from a healthy area, often from the patient's knee, although it can also be taken from the talar articular facet near the lesion. The harvesting process requires precision, as the graft must be obtained in a manner that preserves the integrity of the tissue. Once harvested, the graft is shaped and sized to fit the prepared recipient site on the talus, ensuring a proper fit to promote healing and integration. This meticulous process is repeated until the defect in the talus is adequately filled or until no further healthy tissue is available for harvesting.