Focalplasty for Resurfacing of Focal Articular Lesions of the Medial Femoral Condyle.

BACKGROUND: Focal osteochondral defects of the knee are difficult to manage, as untreated lesions may progress to early osteoarthritis. The OvertureTi Knee Resurfacing System is designed to treat focal defects while preserving native bone, cartilage, and soft tissue. INDICATIONS: Focalplasty is indicated in patients with compartmentalized cartilage lesions, preserved ligamentous stability, and meniscal integrity or repairable tears. Appropriate alignment, joint space preservation, and minimal osteophyte formation are required. TECHNIQUE DESCRIPTION: The procedure began with arthroscopic repair of the medial meniscus root using a transtibial pull-out technique. Following this, an open approach was performed to expose the medial femoral condyle. The chondral defect was sized, and appropriate instrumentation was used to prepare the site. Cartilage scoring and sequential reaming were performed to achieve the desired depth and contour. Trial components were confirmed to fit and position, after which peg holes were drilled and filled with bone cement. Finally, the oblong OvertureTi femoral implant was seated flush with the surrounding cartilage surface, and standard wound closure was completed. RESULTS: At 2 weeks, radiographs confirmed proper implant positioning. Long-term outcomes of the Overture prosthesis are not yet available. However, studies on similar implants, such as the HemiCAP, have reported improved function and survivorship at mid- to long-term follow-up. DISCUSSION/CONCLUSIONS: The Overture prosthesis offers advantages over arthroplasty and biologic resurfacing, including lower cost, off-the-shelf availability, preservation of native tissues, and bone conservation for future arthroplasty. Larger prospective studies are required to determine its long-term clinical efficacy. PATIENT CONSENT DISCLOSURE STATEMENT: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.