Surgical Videos: Knee

Patient history & diagnosis: Subject is a 47 year old male soccer player with chronic anterior left knee pain, which is worse when he is climbing stairs or performing deep knee bends. Physical examination included a careful evaluation of patellar tracking and anatomic factors related to patello-femoral malalignment. Magnetic resonance imaging revealed an osteochondral defect on femoral-trochlear groove.

Arthroscopic procedure: 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 size of the lesion was classified by the Noyes score as grade 3B, 2cm².

Microfractures: Microfractures were then made in the exposed bone about 3 to 4mm apart according to Steadman technique.

Application of HYALOFAST^®: The HYALOFAST^® scaffold was cut to fit the chondral defect and then inserted using an arthroscopic cannula to facilitate the product positioning on the osteochondral defect and to help avoid scaffold damage that may occur through the arthroscopic portal.

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.

Adhesion of HYALOFAST^®: The fast adhesion of HYALOFAST^® scaffold into the osteochondral defect was obtained without application of fibrin glue or other fixation means.

HYALOFAST^® stabilization test: Several cycles of knee flexion and extension under arthoscopic visualization were performed to ensure the graft stability.