Background This video presents the case of a 60-year-old man with >90% lateral plateau bone loss methicillin-resistant Staphylococcus aureus osteomyelitis in the setting of an acute Schatzker type II tibial plateau fracture. Purpose This video and case presentation demonstrate a novel technique to reconstruct the lateral tibial plateau by using autograft. Methods The anatomy and examination, diagnosis, and treatment options are reviewed. Ipsilateral tricortical iliac crest autograft is inverted and used as the lateral tibial plateau articular surface (concave inner table of the pelvis). The standard lateral tibial plateau fixation construct is used to achieve union and a stable knee through which the patient can bear weight and ambulate without the need of bracing or assistive devices. Results At the 3-month postoperative visit, the patient had a healed lateral tibial plateau. There was mild depression of the joint line compared with intraoperative radiographs owing to the patient’s noncompliance (the patient began immediately weight-bearing postoperatively). Despite this, the patient reported the ability to ambulate without a brace and that he used a cane intermittently. Conclusions This is a novel technique that may provide a reconstructive option for the rare case of complete plateau bone loss that produces proximal tibia bone stock to potentially improve the ability to perform a less complicated arthroplasty procedure in the future.