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 cartilage-and-bone graft is transferred from a healthy, non-weight-bearing area of the patient’s knee to restore the damaged cartilage surface.

Here, we see a right knee with the inner side of the knee on the right side of the screen. Incisions have already been made along the front and outer portions of the knee, and the knee is bent to expose the end of the femur, or thigh bone. A small cartilage defect is visible on the inner portion of the femur, which will be repaired using a cylindrical cartilage-and-bone plug harvested from another area of the knee.

The surgeon moves to the outer side of the femur and uses a harvesting instrument to outline and remove the cartilage plug. The instrument is tapped into place and rotated to cut the plug from the underlying bone. The surgeon then returns to the inner femur and uses a reamer to remove a matching circular section of damaged cartilage and bone, creating a socket that precisely matches the harvested plug.

The harvested plug is shaped as needed to ensure proper fit, then aligned and rotated into the prepared socket until it sits flush with the surrounding cartilage. To address the donor site, a cadaveric graft is inserted into the area where the plug was removed, gently tapped into place to fill the remaining gap.

The surgeon closes the skin incisions with sutures, and the cartilage defect repair procedure is complete.