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An aluminium template is helpful for defining the lesion’s extent. At this time, a bone graft may be implanted in osteochondral lesions. FIGURE 4C-3 After curettage of the lesion, the microfracturing may be performed every 5 mm. Step 5: Fixation of Matrix with PAF The matrix is glued directly onto the prepared defect and is adjusted digitally. Finally the knee joint is held in an extended position for 5 minutes (Fig. 4C-4, A-H). Afterward, flex the knee 10 times to test the stability and correct position.

Osteologie. 2000;9:17-25.  Brittberg M, Winalski CS. Evaluation of cartilage injuries and repair. J Bone Joint Surg Am. 2003;85-A(Suppl 2):58-69.  Lu Y, Markel MD. Thermal treatment for articular cartilage: basic science and clinical review. In: Zanasi S, Brittberg M, Marcacci M, eds. Basic science. Clinical repair and reconstruction of articular cartilage defects: current status and prospects. Bologna, Italy: Timeo Editore; 2006:135-148.  Kääb MJ, Bail HJ, Rotter A, Mainil-Varlet P, Gwynn I, Weiler A.

Debrided defect FIGURE 4A-4 Debridement of calcified cartilage. CHAPTER 4A Bone Marrow Stimulating Techniques Arthroscopic burr abrading bone FIGURE 4A-5 A burr abrading bone. Punctate bleeding bone surface in defect FIGURE 4A-6 Punctuate bleeding. A smooth surface must be created, avoiding any divots. Any hypertrophic or sclerotic bone must be removed. After completion of abrasion and confirmation of bleeding, avoid irrigating or disrupting coverage of the defect. Select an appropriate size drill bit or K-wire and attach to the drill.

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