Sixteen patients (13 males and three females; average age, 27 years) with large symptomatic osteochondral defects of the femoral condyle were treated with an osteochondral autograft taken from the ipsilateral lateral patellar facet. Two patients had bilateral procedures for a total of 18 knees. These patients were followed up prospectively with an average followup of 7.6 years (range, 2-14.6 years). Cincinnati knee scores showed significant changes, from an average preoperative score of 37 to an average final followup score of 85. In all of the patients, knee function was improved, and they were able to return to their normal lifestyle with minimal or no restriction. Eighty-one percent of patients have returned to a high level of functioning.