Extensive Arthroscopic Chondroplasty for Cartilage Hyperplasia of the Femoral Condyle Causing Recurrent Knee Locking in a Patient With Multiple Epiphyseal Dysplasia  Jonathan E.J. Koch, M.D., Gideon Mann, M.D., Iftach Hetsroni, M.D.  Arthroscopy Techniques  Volume 5, Issue 2, Pages e229-e234 (April 2016) DOI: 10.1016/j.eats.2015.11.006 Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 1 Anteroposterior and lateral left knee radiographs showing typical epiphyseal irregularities in this patient with multiple epiphyseal dysplasia. There is no evidence for ossified loose bodies. Arthroscopy Techniques 2016 5, e229-e234DOI: (10.1016/j.eats.2015.11.006) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 2 Coronal and sagittal T1-wighted left knee magnetic resonance imaging showing hypertrophy of the articular cartilage in a wavy irregular pattern in this patient with multiple epiphyseal dysplasia. There is no evidence for loose bodies, unstable chondral flaps, or unstable tears of the menisci. Arthroscopy Techniques 2016 5, e229-e234DOI: (10.1016/j.eats.2015.11.006) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 3 Left knee arthroscopic view through anterolateral portal showing suprapatellar pouch free of any loose bodies. Arthroscopy Techniques 2016 5, e229-e234DOI: (10.1016/j.eats.2015.11.006) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 4 Left knee arthroscopic view through anterolateral portal showing minimal irregularities of the trochlear groove chondral surface. Arthroscopy Techniques 2016 5, e229-e234DOI: (10.1016/j.eats.2015.11.006) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 5 Left knee arthroscopic view through anterolateral portal showing irregularity of the central-medial portion of the medial femoral condyle (arrows) without areas of chondral instability, intact medial meniscus body, and intact medial tibial plateau. Arthroscopy Techniques 2016 5, e229-e234DOI: (10.1016/j.eats.2015.11.006) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 6 Left knee arthroscopic view through anterolateral portal with the knee held at 20° flexion and valgus stress showing intact medial meniscus, intact medial femoral condyle chondral surface, and intact medial tibial plateau. Arthroscopy Techniques 2016 5, e229-e234DOI: (10.1016/j.eats.2015.11.006) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 7 Left knee arthroscopic view through anterolateral portal with the knee held at deep flexion revealing extensive chondral flaps of the posterior aspect of the medial femoral condyle over-riding the posterior horn of the medial meniscus. Arthroscopy Techniques 2016 5, e229-e234DOI: (10.1016/j.eats.2015.11.006) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 8 Left knee arthroscopic view through anterolateral portal showing the use of a 4.0-mm resector shaver (Stryker) used for performing gentle chondroplasty of the unstable chondral flaps. Arthroscopy Techniques 2016 5, e229-e234DOI: (10.1016/j.eats.2015.11.006) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 9 Left knee arthroscopic view through anterolateral portal showing overall intact anterior cruciate ligament (ACL). Arthroscopy Techniques 2016 5, e229-e234DOI: (10.1016/j.eats.2015.11.006) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 10 Left knee arthroscopic view through anterolateral portal with the knee held at a flexed figure-of-4 position showing extensive chondral flaps of the posterior aspect of the lateral femoral condyle. Arthroscopy Techniques 2016 5, e229-e234DOI: (10.1016/j.eats.2015.11.006) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 11 Left knee arthroscopic view through anterolateral portal showing the use of an arthroscopic grasper (Acufex, Smith & Nephew) to remove resected pieces of unstable chondral flaps. Arthroscopy Techniques 2016 5, e229-e234DOI: (10.1016/j.eats.2015.11.006) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 12 Left knee arthroscopic view through anterolateral portal showing the smoothened lateral femoral condyle at the completion of the resection. Arthroscopy Techniques 2016 5, e229-e234DOI: (10.1016/j.eats.2015.11.006) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions