Case Presentation Bulk Osteochondral Taekwondo Instructor · History 40 y.o. 5th Degree Black Belt...
Transcript of Case Presentation Bulk Osteochondral Taekwondo Instructor · History 40 y.o. 5th Degree Black Belt...
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Case Presentation Bulk
Osteochondral
Taekwondo Instructor
Deryk Jones, MD
Head
Ochsner Sports Medicine Institute - OSMI
Professor University of Queensland
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Disclosure Statement
Vericel Consultant
Zimmer Consultant
Musculoskeletal Transplant Foundation (MTF)
Board of Directors
Fellowship Support
Smith and Nephew
Arthrex
Depuy/Synthes - Mitek
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History
40 y.o. 5th Degree
Black Belt
VAS 7/10
PAIN / SWELLING
RIGHT KNEE
PR IOR LEFT KNEE
ACLR 80’S
HEIGHT 5’ 10”
WEIGHT 260 LBS
ROM
LEFT : 3 – 130 DEGREES
RIGHT: 5 -130 DEGREES
+ PATELLA GRIND
MILD TILT SUBLUXATION
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Preoperative PA WB Views
Lateral View
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Long Leg Radiographs
Preoperative
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Patellofemoral Joint
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Intact ACL
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Medial Compartment
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Lateral Compartment
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Loose Body Removal
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Large Trochlear Grade 4A Lesion
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Patellar Grade 2 Lesion
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Medial 22.5 mm Lesion
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Site Preparation 22.5 mm Dowel
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OP-1 placed at Base defect
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Osteochondral Allograft Whole Fresh
Femur
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22.5 mm Dowel Graft
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Trochlear Bulk Allograft
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Open View Trochlear Defect – Entire
Proximal Femoral Involvement
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Bulk Allograft Positioned
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1.8 mm Chondral Darts
Reverse Thread
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Multiple Peripheral
Chondral Darts
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Additional Titanium 2.0 mm Screws
Peripheral – Nonarticular Edge
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Postoperative Standing AP /
Merchant’s Radiographs 6 months
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Postoperative PA WB views
Standing AP Views 6 months
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Postoperative Radiographs
Lateral / Merchant’s – 2 year
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Sagittal Images – 2 years post-
implantation
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MRI Cartilage specific sequences
2 years postoperatively
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T2 mapping Axial Images
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Cartilage specific Sequences – 2 years
post-implantation
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Tears ACL – Repeat Arthroscopic
2 years After Implantation
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ACL Tear and Medial 22.5 mm Dowel
Allograft
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Lateral Compartment
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ACL Tear
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Tunnel Preparation
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Tunnel Preparation
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ACL BPTB Graft Application
Central Autograft – 10 x 90 mm
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ACL Graft Fixation
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BPTB GRAFT
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Post-ACL Reconstruction
Healed Bulk and Dowel Allografts