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Chapter 32 Video 1: Fixation of OCD of the Knee

January 05, 2018

Contributors: Kevin G Shea, MD

Subchondral bone drilling works well for stable OCD lesions in skeletally immature patients. Subchondral bone drilling combined with fixation may work well for more advanced but slightly unstable lesions. More unstable lesions are not candidates for isolated subchondral bone drilling and screw fixation. Bone grafting, fixation, or more advanced techniques (OC allograft, ACI, OATS) may be necessary with more advance/unstable cases. The ROCK Arthroscopy Classification demonstrates visual examples of both stable and unstable lesions. Surgical steps are outlined and include pre-op planning, evaluation of lesion stability, setup of the mini C-arm, drilling, screw fixation, and the capture of multiple C-arm images.

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