Arthroscopic Bone Marrow Aspirate Concentrate Harvesting From the Intercondylar Notch of the Knee Gun Min Youn, B.A., Brittany M. Woodall, D.O., Nicholas.

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Arthroscopic Bone Marrow Aspirate Concentrate Harvesting From the Intercondylar Notch of the Knee Gun Min Youn, B.A., Brittany M. Woodall, D.O., Nicholas Elena, M.D., Edward C. Shin, M.D., Neil Pathare, M.D., Patrick J. McGahan, M.D., James L. Chen, M.D., M.P.H. Arthroscopy Techniques Volume 7, Issue 11, Pages e1173-e1176 (November 2018) DOI: 10.1016/j.eats.2018.07.016 Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 1 Insertion of the guide pin. (A) Intraoperative photo of arthroscopy-guided guide pin placement viewed from outside of the right knee. (B) Arthroscopic view of guide pin placement viewed from the lateral portal of the right knee. Arthroscopy Techniques 2018 7, e1173-e1176DOI: (10.1016/j.eats.2018.07.016) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 2 Advancement of the aspiration needle. (A) Intraoperative photo of arthroscopy-guided aspiration needle advancement, viewed from outside of the right knee. (B) Arthroscopic view of aspiration needle advancement viewed from the lateral portal of the right knee. Arthroscopy Techniques 2018 7, e1173-e1176DOI: (10.1016/j.eats.2018.07.016) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 3 Removal of the inner trocar of the aspiration needle during femoral notch bone marrow harvest of the right knee. Arthroscopy Techniques 2018 7, e1173-e1176DOI: (10.1016/j.eats.2018.07.016) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 4 The 30-mL syringe, preloaded with 5 mL of acid-citrate-dextrose formula A, is connected to the adaptor of the aspiration needle, which has been placed through the medial portal and into the femoral notch during the bone marrow harvest of the right knee. Arthroscopy Techniques 2018 7, e1173-e1176DOI: (10.1016/j.eats.2018.07.016) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 5 The 30 mL syringe with acid-citrate-dextrose formula A (ACD-A), connected to the aspiration needle and locked at 30 mL of negative pressure to aspirate bone marrow from the femoral notch of the right knee. Arthroscopy Techniques 2018 7, e1173-e1176DOI: (10.1016/j.eats.2018.07.016) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 6 The Angel System. (A) The bone marrow aspirate will be injected in the rightmost bag (whole blood in), and the automated process will start dividing the different blood components. First the platelet-poor plasma (PPP) will be discarded in the leftmost bag (PPP out). Then the bone marrow concentrate (BMC) will be collected in the syringe on top of the system, and finally the red blood cells (RBCs) will be collected in the bag in the middle. The length of this process depends on the quantity of bone marrow aspirate used. In this case, it was approximately 17 minutes for 60 mL of aspirate. (B) The syringe with the harvested bone marrow is screwed in, and the bone aspirate is injected in the rightmost bag; the centrifugation process is about to start. Arthroscopy Techniques 2018 7, e1173-e1176DOI: (10.1016/j.eats.2018.07.016) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions