Surgical Videos: Knee

Patient history & diagnosis:

Subject is a 23 year old male soccer player presenting with 6 months of traumatic, gradually progressive left knee pain exacerbated by prolonged standing and walking. Left knee MRI scan revealed a focal osteochondral lesion that involved the lateral femoral condyle.

The arthroscopic debridement:

The arthroscopic procedure was performed using the standard anterolateral and anteromedial approaches, including debridement of the osteochondral lesion to remove fibrous tissue and to obtain a stable wall of healthy cartilage and subchondral bone.

Lesion classification:

The lesion was classified by the Noyes score as grade 3B, 4cm².

Microfractures:

Microfractures were performed according to Steadman making holes 4mm apart.

CO₂ joint distension:

CO₂ can be used to obtain joint cavity distension in order to gain a better view of the lesion and to facilitate the scaffold’s positioning.

HYALOFAST shaping and arthroscopic application: The HYALOFAST® scaffold was cut to fit the chondral defect and then inserted directly into the articular cavity through the anterolateral portal and gently adapted to the chondral defect by using the probe. The fast adhesion of HYALOFAST® scaffold into the osteochondral defect was obtained without application of fibrin glue.

HYALOFAST stabilization test:

Several cycles of knee flexion and extension under arthroscopic visualization were performed to ensure the graft stability.