VIDEO: Vascular Trauma in Knee Injuries

Grand Rounds at University of Washington. Discussing the importance of recognizing vascular injuries in the setting of knee trauma and the devastating limb-threatening consequences of missed vascular injuries.

Dr. Nels E. Sampatacos, surgery resident with UW Medicine, begins the lecture with a case study along with functional anatomy concepts.

Dr. Benjamin W. Starnes, chief of vascular surgery for UW Medicine, shares his personal military experience as a vascular surgeon, providing unique insight into front-line management protocols.

Dr. Christopher J. Wahl, assistant professor with the University of Washington, discusses orthopaedic perils and pitfalls, focusing on the radiographic findings suggestive of vascular injury in the setting of knee dislocation.

OATs | OCA: Osteoarticular Transplant | Osteochondral Allograft

When a patient has a large cartilage defect in the knee, our preferential treatment is an OATs (osteoarticular transplant) with allograft (donor bone).  This technique allows us to resurface a large defect and match the contour of the recipient site. We prefer this procedure over others (microfracture, ACI/Carticel, DeNovo, etc) because it restores the exact architecture of the native bone-cartilage interface (subchondral bone capped with mature, hyaline cartilage with viable chondrocytes). This defect required 2 plugs, which is often called a “snowman” technique.

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1️⃣Open findings of the OCD (osteochondral defect).
2️⃣Arthroscopic findings of the OCD (osteochondral defect).
3️⃣Harvested donor "plug”; showing the bone-cartilage interface. 
4️⃣The plug is advanced until flush with the surrounding native cartilage.
5️⃣A second 20 mm donor plug is placed to fill the defect.
6️⃣“Profile” of the plugs matching the contour of the native femoral condyle.