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Advanced elbow surgery in operating theatre

EOAT

EOAT (Elbow Osteoplasty with Augmented Transplantation) is the elbow counterpart to the KOAT technique. It is designed for focal cartilage and subchondral bone defects, most commonly affecting the capitellum or trochlea, where both the cartilage layer and the underlying bone require attention. By reshaping the bone first and augmenting the surface with cartilage, EOAT creates a stable, congruent elbow joint surface. Offered at London Cartilage Clinic for selected patients where standard cartilage repair alone would not address the underlying bone problem.

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Prof Paul LeeReviewed byProf Paul LeeLast reviewed 1 May 2026
Interior view of joint during arthroscopic assessment

Why bone shape matters for elbow cartilage survival

The capitellum and trochlea articulate with the radial head and ulna across a small, high-load surface. If the bone beneath the cartilage is irregular or has collapsed after osteochondritis dissecans or trauma, a cartilage graft alone will not sit on a stable foundation.

  • Osteoplasty reshapes the capitellar or trochlear bone to restore geometry.
  • Cartilage augmentation is then applied to the prepared, congruent surface.
  • The combined approach addresses the structural cause rather than patching over the problem.

EOAT is often considered after a previous elbow cartilage procedure has failed because the bone contour was not corrected at the time of the original surgery.

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The procedure and what to expect

EOAT is performed as a single-stage operation. The bone is reshaped first, then cartilage tissue is transplanted or augmented onto the prepared surface to create a smooth, congruent elbow joint surface.

  • Sling or brace for two to four weeks post-operatively.
  • Early range-of-motion physiotherapy to prevent stiffness.
  • Return to activity guided by imaging and clinical assessment of graft incorporation.

EOAT is a specialist procedure offered to a selected group of elbow patients. Your surgeon will determine whether this combined approach is appropriate based on imaging, defect characteristics, and prior surgical history.

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Professor Lee discussing surgical options

You may have more options than you think

Most patients have more treatment options than they have been told

At London Cartilage Clinic we follow a structured clinical framework across four areas of treatment. Before recommending a single procedure, we assess which combination of approaches gives you the best outcome.

Preserve

Protect what you have. Slow degeneration and manage symptoms.

Repair

Fix specific damage. Torn tissue, unstable joints, structural problems.

Regenerate

Rebuild lost tissue. Biological treatments that stimulate new growth.

Replace

When other options are exhausted. Joint replacement as a last resort.

Explore the full range of treatments available for your joint. Each hub page shows every option we offer, organised by clinical approach.

Explore Elbow Options
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Frequently Asked Questions

What does EOAT stand for?

EOAT refers to Elbow Osteoplasty with Augmented Transplantation. It is the elbow equivalent of the KOAT technique used in the knee, combining bone reshaping with cartilage augmentation in a single operation.

When is EOAT considered for the elbow?

EOAT is considered for focal cartilage and subchondral bone defects in the elbow, most commonly the capitellum or trochlea, including osteochondritis dissecans of the capitellum in throwing athletes and post-traumatic cartilage damage. The technique is suited to defects where the bone contour itself is irregular and would not support a simple cartilage graft.

How does EOAT differ from a standard elbow cartilage procedure?

Standard cartilage procedures address the cartilage surface only. EOAT addresses the bone first, reshaping it to restore the normal articular contour, and then applies a cartilage augmentation onto the prepared surface. The combined approach is appropriate where the bone problem caused or contributed to the cartilage failure.

What is the recovery after EOAT in the elbow?

A sling or brace for two to four weeks with supervised early range-of-motion exercises to prevent stiffness, which is the principal risk in elbow recovery. Light activity returns from six to ten weeks, with sport-level loading from four to six months depending on defect size and progress.

Still have more specific concerns?

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