Aims: To evaluate clinical and radiological results and to present variant of possible mosaicplasty application for treatment of large osteochondral defects. Methods: Between 1998 and 2001, seven patients were operated on with a large osteochondral defect of the femoral condyle using the cylindrical grafts. The age of the þve male and two female ranged from 19 to 27 years. Initially all of them suffered from an osteochondrosis dissecans which was located at the typical site on the medial condyle of the femur. A cylindrical graft is taken from the medial rim of the femoral trochlea, away from femoropatellar weight-bearing areas, with a cylindrical cutter of the 6–11 mm diameter. The hole of recipient site is prepared with a same cutter less by 1 mm diameter. A next graft is inserted in the same way and can cross from preceding graft. The procedure is repeated 2–3 times. The grafts should cover at least 90% of the cartilage defect. Results: The follow-up study was from 1 to 3 years and showed an improvement from 37 points preoperatively to 87 points postoperatively (Cincinnati knee score). All patients returned to there previous professions as well as mild sports activity. Conclusions: For the operative treatment of large chondral defects at the femoral condyle autologous osteochondral transplantation using the cylindrical grafts with mosaicplasty seems to be a successful alternative.