Surgical Videos: Knee

Patient history & diagnosis:

Subject is a 35 year old female surfer presenting with 1 year of traumatic, chronic right knee pain initially treated with physical therapy, oral anti-inflammatory medication and activity modification protocol. The arthroscopic procedure was performed using the standard anterolateral and anteromedial portals, including debridement of osteochondral lesion to remove fibrous tissue and to obtain a stable wall of healthy cartilage and subchondral bone.

Lesion identification:

Right knee MRI scans revealed a focal osteochondral lesion involving the medial femoral condyle.

Lesion classification:

The size of the lesion was classified by the Noyes score as grade 3B, 1.5cm².

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.