Cartilage Surgery

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Firm pressure is applied to the sizing tube over the plug to ensure that the plug does not move and the tube is removed. Tip: It is important to ensure that the tamp is fully bottomed out by pushing on the extruded plug. Bear in mind that the outer sleeve needs to be referenced off the intended height of the articular cartilage, not the bottom of the defect; otherwise a false level is achieved. FIGURE 4D-11 Both the drill and the drill sleeve are then removed simultaneously. CHAPTER 4D Bone Marrow Stimulating Techniques Step 9 The excess of the protruding plug is then cut, using the sharp, supplied knife (Fig.

PEARLS AND PITFALLS Radical excision is crucial. All flaps and fissures must be excised. The most common error is not to be radical enough (Fig. 3-11). Start with a raspatorium or ring curette. A shaver can be used from a central position first when the defect has been debrided to vertical walls. All of the lesions in category ICRS 3 are simply defined as defects that extend through >50% of the cartilage thickness, through the cartilage but not through the subchondral bone plate. Debridement of unstable edges (as is suggested for ICRS-2 lesions) is suitable also for ICRS-3 lesions, but further treatment is recommended for these more extensive lesions.

Arthroscopy. 1986;2:54-69.  Pridie KH. A method of resurfacing osteoarthritic knee joints. J Bone Joint Surg BR. 1959;41:618-619.  Steadman JR, Rodkey WG, Singleton SB, Briggs KK. Microfracture technique for full thickness chondral defects: Technique and clinical results. Oper Tech Orthop. 1997;7:300-304. Carbon is biocompatible and inert. Carbon fibers are strong in tension. The matrix of carbon fiber materials become infiltrated with connective tissue and, ultimately, organized collagen fibers, thus forming a strong “biological composite” material.

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