Fresh Osteochondral and Meniscus Allografting for Post-traumatic Tibial Plateau Defects  Pablo E. Gelber, M.D., Ph.D., Juan I. Erquicia, M.D., Eduard Ramírez-Bermejo, M.D., Oscar Fariñas, M.D., Juan C. Monllau, M.D., Ph.D.  Arthroscopy Techniques  Volume 7, Issue 6, Pages e661-e667 (June 2018) DOI: 10.1016/j.eats.2018.02.010 Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 1 Left knee, lateral view. The least amount of bone necessary to obtain a flat, bleeding bone is removed. The iliotibial band (ITB) is retracted proximally to improved visualization with a pulling suture. Arthroscopy Techniques 2018 7, e661-e667DOI: (10.1016/j.eats.2018.02.010) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 2 Left knee, lateral view. If the patient's meniscus is being preserved, traction sutures pull it proximally to allow for improved visualization. Arthroscopy Techniques 2018 7, e661-e667DOI: (10.1016/j.eats.2018.02.010) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 3 Vertical sutures every 10 mm are placed along the meniscus for later fixation to the patient's capsule. Arthroscopy Techniques 2018 7, e661-e667DOI: (10.1016/j.eats.2018.02.010) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 4 Left knee, lateral view. The graft is being washed with a pulsatile lavage irrigation system inside a 0.5 L saline solution recipient. All the unnecessary soft tissue is resected. Both actions help to decrease the graft's immunogenicity. Arthroscopy Techniques 2018 7, e661-e667DOI: (10.1016/j.eats.2018.02.010) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 5 Left knee, lateral view. The passing sutures that had been passed through the patient's capsule (A) allows the sutures previously inserted in the meniscus of the allograft to be retrieved (B, C) to perform the meniscocapsular fixation. Arthroscopy Techniques 2018 7, e661-e667DOI: (10.1016/j.eats.2018.02.010) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 6 Left knee, lateral view. The osteochondral graft is being fixed with 2 titanium headless compression screws (Acutrak Standard; Acumed). Arthroscopy Techniques 2018 7, e661-e667DOI: (10.1016/j.eats.2018.02.010) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 7 Left knee, lateral view. Those sutures placed in the posterior half of the meniscus are tightened with sliding knots pushed back with a shoulder knot-pusher. Arthroscopy Techniques 2018 7, e661-e667DOI: (10.1016/j.eats.2018.02.010) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 8 Left knee, lateral view. Final clinical and 3-dimensional computed tomography aspect of the fresh osteochondral lateral tibial plateau and meniscal transplantation. Transosseous sutures help to properly close the joint. Arthroscopy Techniques 2018 7, e661-e667DOI: (10.1016/j.eats.2018.02.010) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions