Knotless Suture Anchor Fixation of a Traumatic Osteochondral Lesion of the Lateral Femoral Condyle

Osteochondral injuries commonly occur after lateral patellar instability events. Recognition and early intervention of displaced fragments is key to maintaining the viability of the fragment and congruency of the articular surface. Multiple fixation techniques exist for achieving stable fixation of displaced osteochondral lesions, including metal or bioabsorbable screws and all suture techniques. In this Technical Note, we describe a technique for internal fixation of a displaced osteochondral fragment of the lateral femoral condyle using knotless suture anchors. This technique affords minimally invasive restoration of the native anatomy with excellent stability of the fracture fragment, allowing early range of motion and ambulation.
Technique Video Video 1 Intraoperative video demonstrating diagnostic arthroscopy with identification of an osteochondral fragment in the posterolateral recess of the knee and the corresponding defect along the lateral femoral condyle. Subsequent removal of fragment and evaluation on the back table. Debridement of the base of the osteochondral defect followed by marrow stimulation of the defect bed. Placement of knotless fiberTak anchors (Arthrex, Naples, FL) was followed by preparation of the fragment on the back table for knotless suture anchor fixation. The fixation limb is fed through the drill holes in the osteochondral fragment and a knotless interconnection between anchors is created. Gentle passage and final fixation of the osteochondral fragment follows.