Arthroscopic Treatment of Medial Femoral Knee Osteochondral Defect Using Subchondroplasty and Chitosan-Based Scaffold Kelsey Holt, B.Sc., Mark Sorhaindo,

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Arthroscopic Treatment of Medial Femoral Knee Osteochondral Defect Using Subchondroplasty and Chitosan-Based Scaffold Kelsey Holt, B.Sc., Mark Sorhaindo, M.D., Catherine Coady, M.D., F.R.C.S.C., Ivan Ho-Bun Wong, M.D., F.R.C.S.C., Dip. Sports Medicine, M.A.C.M. Arthroscopy Techniques Volume 8, Issue 4, Pages e413-e418 (April 2019) DOI: 10.1016/j.eats.2018.11.022 Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 1 The patient is positioned in the supine position with the right foot placed into a Spider knee holder. Arthroscopy Techniques 2019 8, e413-e418DOI: (10.1016/j.eats.2018.11.022) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 2 View from lateral portal of osteochondral lesion in distal medial femoral condyle. The arrowheads outline the flap edges of the osteochondral lesion. Arthroscopy Techniques 2019 8, e413-e418DOI: (10.1016/j.eats.2018.11.022) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 3 (A) View from lateral portal of grasper holding osteochondral lesion from medial portal. (B) View from lateral portal of curette used to remove attached cartilage of osteochondral lesion in distal medial femoral condyle. (L, osteochondral lesion; P, patella.) Arthroscopy Techniques 2019 8, e413-e418DOI: (10.1016/j.eats.2018.11.022) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 4 (A) Mini C-arm anteroposterior and lateral views of right knee showing cannulated drill (D) from medial femoral condyle. The arrowheads outline the osteochondral lesion. (S, scope.) (B) Outside view of mini C-arm lateral view confirming position of cannulated drill in medial femoral condyle in right knee. (C) Outside view of mini C-arm anteroposterior view confirming position of cannulated drill in medial femoral condyle in right knee. Arthroscopy Techniques 2019 8, e413-e418DOI: (10.1016/j.eats.2018.11.022) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 5 (A) View from medial portal with curette from lateral portal to remove calcific layer off defect in distal medial femoral condyle (M). (B) View from medial portal of medial femoral condyle (M) with Phoenix microfracture drill from lateral portal. (C) View from lateral portal with shaver in medial portal used to drain fluid from inside knee. The needle is inserted percutaneously and attached to suction. (M, medial femoral condyle.) Arthroscopy Techniques 2019 8, e413-e418DOI: (10.1016/j.eats.2018.11.022) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 6 Sequential views from lateral portal showing CarGel used to re-create 3-dimensional scaffold of defect in distal medial femoral condyle (M). (A) Needle with CarGel mixture inserted from medial portal through passport cannula. (B) Sequential filling of defect allowing CarGel to solidify and form 3-dimensional scaffold. (C) Final view of CarGel. Arthroscopy Techniques 2019 8, e413-e418DOI: (10.1016/j.eats.2018.11.022) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions