Knee Joint Cartilage Defects: Small Cartilage Defect Replacement

Knee Joint Cartilage Defects: Small Cartilage Defect Replacement

This cadaveric surgical video demonstrates an osteochondral autograft transplantation, or OATS procedure, used to treat a small cartilage defect in the knee. In this procedure, a piece of cartilage is transferred from a healthy, non-weight-bearing area of the patient's knee to the area of the cartilage defect.

Here, we see a right knee with the inner side of the knee on the right side of the screen. The surgeon has already made incisions along the front of the knee and outer side of the knee. The knee is bent to expose the surfaces at the end of the femur, or thigh bone. Here, we see a small cartilage defect on the inner end of the femur. The surgeon will patch this defect with a piece of cartilage and bone, called a plug or graft, that will be taken from the other side of the knee.

The surgeon moves to the outer side of the femur and uses a harvesting instrument to mark out where the plug will be removed. The instrument is tapped in place and rotated to cut out a plug from the rest of the bone. The surgeon then moves back to the inner end of the femur and uses a reamer to cleanly cut out a round section of cartilage and bone around the cartilage defect. This makes a hole that will allow the plug to neatly fit into.

The surgeon shapes the end of the harvested plug to achieve the correct size. Then, the surgeon aligns the harvested plug and rotates the instrument to insert the plug into the hole where the defect was removed. The surgeon moves back to the outer side of the knee to insert a graft taken from a cadaver to fill in the space where the cartilage and bone were removed. The surgeon positions the graft and gently taps it into place to fill in the gap.

The surgeon will use sutures to close the skin incisions, and the procedure is now complete.