Name: OATS® Surgical Technique
Uploaded: 2012-07-06T00:00:00Z
Channel: Arthrex

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LCD0164A-2 | A | OATS® Surgical Technique

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A general overview including the relevant steps of an Arthrex surgical technique. These animations always include a voice-over explaining the process.

Eine allgemeine Übersicht, einschließlich der relevanten Schritte einer Arthrex Operationsanleitung. Diese Animationen enthalten immer Voice-Overs, die den Prozess erklären.

Operationstechnik-Animationen

Surgical Technique Animations

Visão geral incluindo as etapas relevantes de uma técnica cirúrgica Arthrex. Essas animações sempre incluem uma narração explicando o processo.

Animações de técnicas cirúrgicas

Descripción general que incluye los pasos relevantes de una técnica quirúrgica de Arthrex. Estas animaciones siempre incluyen una voz en off que explica el proceso.

Animaciones de técnicas quirúrgicas

OATS® Surgical Technique

The Arthrex OATS surgical technique. The following surgical technique illustrates the surgical treatment for full thickness femoral osteochondral defects of the knee. The OATS technique utilizes a series of tube harvesters with colored pins to harvest autogenous cores of bone capped with hyaline cartilage, which are then transferred to the damaged area of the femoral condyle. This technique may be performed in all areas of the knee joint. The OATS technique may be carried out as an open or arthroscopic procedure. The leg is secured in the Arthrex low profile leg holder. The osteochondral defect is inspected arthroscopically and the size of the lesion is measured. A set of OATS sizer tamps are available in five through ten millimeter diameters, and are used to precisely determine the Determine the diameter of the defect. The Siser stamps are color coded to correspond with the tube harvester sterile sets used to carry out the procedure. These instruments are also used to determine donor sites above the lateral sulcus terminalis. The tube harvester driver extractor is assembled as shown. The OATS donor tube harvester is first loaded into the base of the driver extractor, and the chuck is tightened. A cartilage protector cap is inserted into the back of the driver extractor. When seated, the collared pin will protrude a few millimeters past the sharp cutting tip of the harvester. Avoiding damage to the articular surfaces during harvest or insertion into the joint, the donor harvester is introduced into the knee and positioned superior to the sulcus terminalis region. Once an acceptable area for graft harvest is established, the harvester is maintained perpendicular to the bone surface and the cartilage protector cap is removed. The donor harvester is driven with a mallet into subchondral bone to a depth of approximately 15mm. Care is taken to avoid rotating the tube harvester during impaction. Once the selected depth is reached, remove the harvester and captured bone core by axially loading the harvester and rotating the driver extractor 90 degrees clockwise and then 90 degrees counterclockwise. The length of the donor core and hyaline cartilage thickness can be seen through the slots in the harvester, and measured for overall length. Next, the recipient tube harvester with collared pin is fully inserted into the tube harvester driver extractor, and the cartilage Protector cap is inserted in similar fashion. If a single core transfer is performed, then the recipient tube harvester is Harvester is positioned to cover the entire defect. Once a perpendicular angle is established to maintain the harvester, the cartilage Protector cap is removed. It is important to maintain a perpendicular position with the harvester throughout the development of the recipient socket. The harvester should be rotated so that the depth markings are visualized, while care is taken to maintain a constant knee flexion angle during the socket creation. Using a mallet, the two harvester is then driven into subchondral bone to a depth of approximately 13mm, or two millimeters less than the length of the donor core. The bone core is extracted in similar fashion as the donor core, and the depth of the core is recorded. A calibrated OATS alignment stick of the appropriate diameter is used to measure the recipient socket depth and align the angle of the recipient socket. Fine adjustments can be made to alter the depth of the socket as needed. The donor core is then reloaded onto the driver extractor and the t-handle section removed. An OATS pin calibrator is then inserted over the collared pin and pressed into the open back end of the driver extractor. The beveled edges of the tube harvester are inserted fully into the recipient socket. This stabilizes the harvester during graft impaction. Once positioned perpendicular to the socket, the guide pin is impacted with light taps of the mallet delivering the core into the recipient socket. The predetermined length of the collared pin is designed to advance the core, so that one millimeter of the graft will remain proud from the recipient socket. When the pin is driven flush with the end of the pin calibrator, the insertion process is visualized through the slotted windows on the tube harvester. A sizer tape measuring at least one millimeter in diameter, larger than the diameter of the bone core, is positioned over the graft core. Final seating of the bone core flush with surrounding cartilage is achieved by tapping the tamp lightly with the mallet. An alternative method of delivering a hyaline cartilage bone core may be performed by inserting the core extruder onto the back of the driver extractor. The core is delivered into the recipient socket by rotating the core extruder in a clockwise fashion. Final seeding of the graft is achieved with an OATS sizer tamp one millimeter larger than the graft if desired. Donor sites may then be filled with allograft bone cores of size equal to the graft taken. The knee is placed through range of motion at the conclusion of the procedure to ensure smooth articular surfaces.