Name: Patella Tendon Harvest Site Grafting with Angel® BMC System
Uploaded: 2017-08-09T00:00:00Z
Channel: Arthrex
Description: Jeffrey A. Macalena, MD, (Minneapolis, MN), provides a case presentation of an autograft BTB ACL reconstruction with backfill of the donor site with demineralized bone matrix (DBM) mixed with the Angel ® BMC system.

<p>Jeffrey A. Macalena, MD, (Minneapolis, MN), provides a case presentation of an autograft BTB ACL reconstruction with backfill of the donor site with demineralized bone matrix (DBM) mixed with the Angel<sup>® </sup>BMC system.</p>

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VPT1-00764-EN | A | Patella Tendon Harvest Site Grafting with Angel® BMC System

Jeffrey A. Macalena

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Patella Tendon Harvest Site Grafting with Angel® BMC System

Hi, my name is Jeff Mceleney. I'm an orthopedic surgeon at the University of Minnesota. Today we're going to talk about a case of mine who we performed an ACL reconstruction on. Our case is an 18 year old male. He's a healthy individual with no significant past medical history, and he's a three sport, high level athlete who is completing his senior year in high school. At the end of the football season, he sustained an injury to his knee. He felt the pop he was unable to continue to play and he had a large swollen knee. During the exam in our office, an MRI was obtained which showed a complete rupture of his anterior cruciate ligament. He also was found to have a vertical tear of the posterior horn of his medial meniscus. Large bone bruises were present, demonstrating the significance of the subluxation event. Ultimately, we offered this patient an ACL reconstruction with Bone-tendon-bone autograft. During our planning stage for this surgical reconstruction, given this athlete's high level status and desire to return promptly to athletic sports. We offered him backfill of his patellar tendon donor site. We plan to do this with a bone marrow aspiration concentrate using the Angel system, as well as a mix of mineralized bone matrix. His ACL surgery is seen here through arthroscopic pictures. He has a complete rupture of his anterior cruciate ligament, placed guide pins on the tibial side, drilled our femoral tunnel and completed an inside out repair of his medial meniscus using two zero FiberWire. After passing of his ACL graft, we allowed the patient to return to his desired activities through a slow and structured rehabilitation process. He was placed into a knee immobilizer to allow initial healing, and then started with a physical therapy protocol. He quickly progressed through the therapy protocol and was able to meet his functional returns, such as weaning from his crutches and a brace, and began to run at approximately eight weeks post-operatively by the three month mark, the patient was starting to return to functional activities and a functional test obtained in our clinic demonstrated excellent strength, motion and control of gait and body mechanics during activities. The patient inquired at that time about possibly returning to compete at the end of his high school basketball season, at approximately four months. Certainly, this was an early return to sports, so we obtained a new MRI. It showed excellent resolution of his graft, but one of the things that I think is most interesting is the excellent fill within the patella from the donor site, seen here on this MRI image. We also bathed his patellar tendon donor site with the Angel bone marrow concentrate. And you can see the minimal edema and excellent resolution along his patellar tendon donor site. Ultimately, this patient was able to return to compete at the highest level and participate in the state basketball tournament.

Patella Tendon Harvest Site Grafting with Angel® BMC System

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