Technical difference | Current technique | Osteo-chondral allograft |
---|---|---|
Approach | Open | Open |
Measurement of defect size | – | Essential |
Reconstructive graft | Autologous fibula | Osteo-chondral allograft (humeral head, femoral head, talus) |
Graft availability | Readily available | Necessity of tissue banking systems |
Graft preparation and fashioning | Simplified | Technically demanding |
Graft bone marrow elements | – | Washed out by copious lavage |
Fixation method | 4 mm Cancellous screws | Press-fit Countersunk screws/pins |
Enhancement of local biology | Microfracture | Platelet-rich plasma |
Concurrent posterior GH capsulorrhaphy and McLaughlin’s procedures | Feasible | Feasible |
Reconstructed articular surface | Lateral surface of native fibula + Fibrocartilage | Articular cartilage |