All-Arthroscopic Implantation of Minced Juvenile Chondral Allograft for an Isolated, Full- Thickness Chondral Lesion in the Trochlea of an Adult Knee  Sean McMillan, D.O., Gregory T. Lichtman, D.O., Christopher Betz, D.O.  Arthroscopy Techniques  Volume 5, Issue 2, Pages e397-e401 (April 2016) DOI: 10.1016/j.eats.2016.01.016 Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 1 A grade III chondral lesion in the trochlea, viewed from the anterolateral portal in a supine patient, is identified and measured to be less than 2.5 cm2. One asterisk, lateral femoral condyle; 2 asterisks, medial femoral condyle; and proportionality symbol, ligamentum mucosum. Arthroscopy Techniques 2016 5, e397-e401DOI: (10.1016/j.eats.2016.01.016) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 2 The lesion, viewed from the anterolateral portal, is debrided using a combination of (A) an arthroscopic biter, (B) a curved curette, and (C) a shaver, which are inserted through the anteromedial portal. One asterisk indicates the lateral femoral condyle, and 2 asterisks indicate the medial femoral condyle. Arthroscopy Techniques 2016 5, e397-e401DOI: (10.1016/j.eats.2016.01.016) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 3 The defect, viewed from the anterolateral portal, has been debrided to subchondral bone with a stable rim on all sides. One asterisk indicates the lateral femoral condyle, and 2 asterisks indicate the medial femoral condyle. Arthroscopy Techniques 2016 5, e397-e401DOI: (10.1016/j.eats.2016.01.016) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 4 Arthrex PassPort Button Cannula placed through the anteromedial portal (psi) in the left knee of a supine patient. The sheath (1 asterisk) from an 18-gauge spinal needle is inserted through the cannula. The arthroscope is seen within the anterolateral portal (2 asterisks). Arthroscopy Techniques 2016 5, e397-e401DOI: (10.1016/j.eats.2016.01.016) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 5 The lesion, viewed from the anterolateral portal, is meticulously dried using an 8F Frazier-tip suction device (1 asterisk) inserted through the cannula in the anteromedial portal (psi). Two asterisks indicate the lateral femoral condyle. Arthroscopy Techniques 2016 5, e397-e401DOI: (10.1016/j.eats.2016.01.016) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 6 The graft material is delivered through the spinal needle sheath and delivered into the chondral defect using an arthroscopic probe (1 asterisk). Psi, cannula from the anteromedial portal; omega, graft material within the defect; and 2 asterisks, medial femoral condyle. Arthroscopy Techniques 2016 5, e397-e401DOI: (10.1016/j.eats.2016.01.016) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 7 Final position of the implant, shown from the anterolateral portal, after the fibrin glue has been applied and allowed to dry for 5 minutes. One asterisk, lateral femoral condyle; psi, cannula from the anteromedial portal; omega, graft material within the defect; and 2 asterisks, medial femoral condyle. Arthroscopy Techniques 2016 5, e397-e401DOI: (10.1016/j.eats.2016.01.016) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions