Name: Treatment of Osteochondral Lesion of the Talus Using the AutoCart™ Procedure
Uploaded: 2019-10-30T00:00:00Z
Channel: Arthrex
Description: Christopher D. Kreulen, MD (Sacramento, CA), performs a single-stage chondrocyte implantation and uses the AutoCart™ procedure to treat an osteochondral lesion of the talus. In this procedure, autologous tissue collected using the GraftNet™ device is mixed with BioCartilage® extracellular matrix.

<p>Christopher D. Kreulen, MD (Sacramento, CA), performs a single-stage chondrocyte implantation and uses the AutoCart™ procedure to treat an osteochondral lesion of the talus. In this procedure, autologous tissue collected using the GraftNet™ device is mixed with BioCartilage® extracellular matrix.</p>

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VID1-000225-en-US | B | Treatment of Osteochondral Lesion of the Talus Using the AutoCart™ Procedure

Christopher D. Kreulen

Human

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

Eine Videoaufnahme einer Operationsanleitung an einem lebenden Patienten oder Patientin in einem Operationssaal oder eine Demonstration an einem Humanpräparat.

Operationstechnikvideos

Surgical Technique Videos

Gravação em vídeo de uma técnica cirúrgica em um paciente em uma sala de cirurgia ou uma demonstração cadavérica.

Vídeos de técnicas cirúrgicas

Grabación en vídeo de una técnica quirúrgica de un paciente en un quirófano o una demostración cadavérica.

Videos de técnicas quirúrgicas

Treatment of Osteochondral Lesion of the Talus Using the AutoCart™ Procedure

Today, we're going to be demonstrating the technique of using GraftNet and BioCartilage for a treatment of osteochondral defect. First, we do an appropriate debridement in the ankle joint for arthroscopy, and we expose the Osteochondral defect. And you see this intact cartilage that we're going to resect using the GraftNet and a shaver. We have our assembled GraftNet system. You have your shaver with a three over eight bone cutter, and you have your GraftNet set up in line with suction and the shaver right here. So now I'm going to loosen up this lesion a little bit more to enable the GraftNet to be more effective. Now the lesion is ready to resect and collect. Now that we've debrided our lesion we measure it for documentation. So that's about a centimeter and then roughly another eight millimeters. And we've got back to stable bone and a stable surrounding. Cartilage border. Once our lesion is debrided, if we think we need marrow stimulation. That's when we perform the marrow stimulation. So here we're going to use the PowerPick. So here we have our setup for our composite osteochondral defect repair system. Once the defect has been debrided back to a stable border, we can then dry out the joint using suction and these cannulated swabs. This is our GraftNet with the autologous tissue collected in the screen. Here is our composite mixing system for the BioCartilage and the autograft tissue. We hydrate it with PRP. Once we have achieved the desired hydration we can then load our ArthroPaddle delivery system. We are going to take out the autologous tissue from the GraftNet. Simply slide the two pieces apart, pull the tissue up out of the screen and you can do it over the collection system. And here is the collected autologous tissue that you can then take and scrape into the funnel. Then we'll take that autologous material place it down into the mixing cannula. Now we are going to load our BioCartilage into the mixing cannula. Now we add our PRP for hydration. Now we're going to go ahead and mix this graft to incorporate the scaffold BioCartilage with the autologous tissue from GraftNet. Now that we are fully mixed we are going to load our ArthroPaddle delivery device. I like to push a little bit out just to make sure we're full at the bottom. Now we are going to prep the joint using the suction swabs. As you can see, they do a very good job of sucking out the fluid and helping dry the joint. And if your camera lens gets a little dirty, you just use it to clean that off. I like to try to push one way into the back to get some of that extra fluid that's back there. Sucked out so it doesn't leak. To the front. Now we are going to add our composite of autologous tissue and BioCartilage. Using our ArthroPaddle to smooth it out to make sure we have enough tissue. We check the lesion to make sure that it is stable. We then remove the camera, close up the portals. Our rehab protocol is two weeks of immobilization, followed by placement into a boot where they can begin non-weight-bearing range of motion activities with physical therapy. Progressive weight bearing starts at 4 to 6 weeks, with full weight bearing at six weeks, and then patients typically transition out of the boot at 8 to 10 weeks. And then we restrict high impact activities such as running until about 4 to 6 months, depending on where the lesion was and the size of the lesion.

Treatment of Osteochondral Lesion of the Talus Using the AutoCart™ Procedure

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