Name: Osteochondral Lesion Treatment With the 20 mm Precut OATS® Kit
Uploaded: 2026-04-10T00:00:00Z
Channel: Arthrex
Description: Stephanie Pearce, MD (Jacksonville, FL), demonstrates an osteochondral allograft transplantation using the 20 mm precut OATS® kit.

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Stephanie Pearce, MD (Jacksonville, FL), demonstrates an osteochondral allograft transplantation using the 20 mm precut OATS® kit.

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English  - en

video

VID1-009392-en-US | A | Osteochondral Lesion Treatment With the 20 mm Precut OATS® Kit

Stephanie Pearce, MD

A video recording of a surgical technique on a live patient in an operating room setting or a cadaveric demonstration.

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Osteochondral Lesion Treatment With the 20 mm Precut OATS® Kit

Speaker  Hi I'm Doctor Stephanie Pierce from Jacksonville, Florida. Today we're going to be working on a 20 millimeter osteochondral allograft transplantation with the Arthrex 20 millimeter Osseo pre-cut kit. This is a convenient option for this size of an osteochondral lesion. In the kit is the dual tamp dilator. This tool is very intriguing. It has the dilator and measuring guide directly on one end. You can see these measurements here allow for easy identification of the depth of the lesion to match your graft. Additionally, there is a guide pin cannulated slot, so this will slide over the guide pin in the center of the lesion to allow for consistent and reliable entry in a seamless fashion into the lesion itself. The Tamp on the other end allows for easy entrance of the OCA graft into the lesion to allow for smooth tamping and flush fit at the completion of the case. So this is the graft delivery tube. This allows for arthroscopic insertion and completion of the OCA allograft, and you can see the dual Tam dilator easily fits into the tube to allow for ease of dilation during the procedure, as well as ease of graft, delivery and graft entrance. So as you can see, we've started our approach. We have a midline incision with a medial parapatellar approach. Here you can see I have marked the superior medial corner of the patella in order to allow for appropriate tensioning of the joint capsule. Speaker  At the completion of our case, after the graft is in to allow for appropriate biomechanics of the knee joint at the end of the Osseo grafting. And here in the center of our medial femoral condyle, we see our lesion. Now this lesion measures approximately 17mm by 19mm. So it's quite large really giving a great option for this 20 millimeter pre-cut OCA graft kit. First I like to take the dual Tam dilator. And we can use this as a measuring guide. It has these beautiful measurements here. And you can see it runs really nicely on the cartilage. So you can find the best position to get the best read. Right now, we can see that the 20 millimeter guide will cover the entirety of our lesion, but is not too large for how large our lesion is. So this is a great fit. Finding the center of this lesion is important. That's where our 2.4mm guide pin is going to come in. And this dual tamp dilator allows us to get right in the center of our lesion and come in directly in the center with our guide pin. You need to enter just enough to get a good hold. And you can see that guide pin is going to be aligning nicely for our reamer. As we're getting ready to ream, we want to ensure to be using fluid to minimize the bone death. And heat damage to the recipient site. Speaker  The nice thing about this reamer is that it has measurements on the reamer itself. So you can see we're coming about to a depth of eight 8 to 10mm, which is ideal. So we'll stop here. Now the reaming is done. We'll clear the debris out of the site here. So after cleaning all of the reaming you can see we've marked the 12:00 position, which is really important for orientation. And in comes the Cannulated dual end tamp also working as our measuring device. So we can see right now it is at ten millimeters at the 12:00 position. And we can get all of our measurements around at each of the 3:00, 6:00 and 9:00 positions. This is one of the strongest pearls that I can recommend, is making sure that we have those precise measurements at each of those corners. That allows for smooth contouring to recreate the articular surface at the contoured shape of the patient's host recipient site. That's going to allow the best match for the Osteochondral allograft to help minimize wear deterioration and improve incorporation and integration of your OCA. So now we've taken the guide pin out and we're going to leave the dilator in place. This will help protect the recipient site, but it will also help create an easier passage of the OCA into the recipient site at the conclusion of the graft preparation. All right. Speaker  So now we're on our back table and we're working with the graft itself. So this is a really nice option because this comes pre-cut and delivered from the package exactly like this. Other than the fact that I marked our 12:00 position. So this is how it is out of the package ready for ease and use. The first thing we want to do is measure the depths. So these need to match. So I like to use a clock face to do this. Some prefer a compass rose, but for me, measuring the 12:00, the 3:00, the 6:00 and the 9:00 are crucial to allow for appropriate contouring to match the host site. That way, there's the least amount of degeneration of the osteochondral allograft. So as we're doing our hour measurements, I like to make sure I have two hands to guide our depth to be as accurate as possible. So the 12:00 is at ten millimeters. We'll rotate to the 3:00 position and that's going to be at nine. Our 6:00 is at 11 and then our 9:00 is also 11. Beautiful. And then I like to connect these. This helps guide my saw blade to ensure an appropriate contour which increases the graph matching reliability. Very rarely do these come exactly equal all the way across. So having this reliable method to create a perfectly matching graph to the host makes this a much more streamlined procedure. So now you can see we have measured the depths of the graft along the various clock face measurements. Speaker  And this allows for an appropriate matching for the contour with the depth of the lesion that has been taken. So I like to use stable towel clamps to hold our graft. So now that the graft is held securely with the towel clamps, it's available to allow for sawing to taper this to the exact size and depth that's needed. Once again, very important to ensure fluid is running during the sawing so we can minimize cell cell death and encourage bone to bone healing and integration. As I'm positioning the graft, I like to have the largest area that needs to be removed closest to me. This allows for the least amount of sore passes in order to have a more efficient cutting method. The graph is toggling, so I readjusted the clamp so that it will have the least amount of movement as the sore is coming across. You can see it's much more stable. Another tip is you can take either the edge of the saw or the rongeur to bevel the edges. That will allow for easier entrance into the dilated recipient site. Now our graft is ready to be soaked with ACP or autologous fluid of your choice. All right, so now we're back to our recipient site. We're going to remove the dilator and this is a key Pearl is to. Speaker  Now lay down a suture tape. The suture tape gives much more control of the graft during insertion to allow for any readjustments or. If you don't like the position of the graft or the depth of the graph, you can take the graph completely out without causing any damage to the cartilage. And now we will insert the graft matching the 12:00 positions. And we'll have our Tamp ready. This is going to be a good tight fit. It's going in really nicely. So a couple of light taps as you're moving around. Always dispersing the forces is really important. Remember remember the chondrocytes are are alive. So you want to have the least amount of traumatic damage to them as possible. And then once it's seated, which is when seating really nicely, I like to take a 15 blade, and this helps to get the fine tuning for the final position to really maximize the cartilage matching for the contour. These are very small slivers, if you will, especially since there's no matching with these pre-cuts. Sometimes you need just a little bit of fine tuning to make it perfect, but it still is a wonderful option. At a faster rate to be able to create a beautiful matching graph with a gorgeous contour matching the patient. And there you have it, a 20 millimeter osteochondral allograft from a pre-cut plug using the Arthrex 20 millimeter pre-cut OCA kit.

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Osteochondral Lesion Treatment With the 20 mm Precut OATS® Kit

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