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All-Arthroscopic Treatment of Dependent Osteochondral Lesions of the Ankle: Surgical Technique

  • Nick R. Johnson
    Affiliations
    Medical Student, College of Medicine, Oklahoma University Health Sciences Center, Oklahoma City, OK
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  • Spencer Skinner
    Affiliations
    Resident, Department of Orthopaedic Surgery, Oklahoma University Health Sciences Center, Oklahoma City, OK
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  • Amgad M. Haleem
    Correspondence
    Address correspondence to: Amgad M. Haleem, MD, PhD, Department of Orthopaedic Surgery, Oklahoma University Health Sciences Center, 920 Stanton L. Young Boulevard, WP 1380, Oklahoma City, OK 73104.
    Affiliations
    Assistant Professor, Department of Orthopedic Surgery, Oklahoma University Health Sciences Center, Oklahoma City, OK

    Assistant Lecturer, Department of Orthopaedic Surgery, Cairo University School of Medicine, Cairo, Egypt
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      Abstract

      A large number of articular cartilage defect treatments have been described. However, few have discussed the use of biologic agents implanted into the so-called dependent defect arthroscopically. Furthermore, even fewer of these reports have contained a description for treating dependent osteochondral lesions of the tibial plafond. Generally, these lesions have been treated with either microfracture or debridement, and the long-term outcomes have been less than satisfactory. With new interest in biologic treatments for osteochondral defects, we believe that bone marrow aspirate concentrate combined with a biologic scaffold provides the necessary components to provide healing of these so-called dependent lesions. We believe that the combination of bone marrow aspirate concentrate and a biologic scaffold create the perfect viscosity to hold their mold in these dependent osteochondral lesions and provide the perfect scaffold to enhance recovery. We believe that our technique provides a minimally invasive option for the treatment of these osteochondral lesions and eliminates the need for a large arthrotomy.

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