Arthroscopic Screw in Situ

Medial femoral condyle

 

Technique

 

Arthroscope in lateral portal

Clear fat pad

Ensure can see entire dimensions of OCD

 

MFC OCD 2

 

If fragment is displaced, reduce and pin with accessory K wire

 

MFC OCD 1MFC OCD 1MFC OCD 7

 

Instrument and screw from accessory medial portal

- fragment is lateral aspect of the MFC

- typically need trans patella tendon portal to ensure correct trajectory

- ensure K wires centered in fragment

 

Flex and extend knee to place inferior / superior screws

- typically 2 - 3 screws maximum (3.5 mm)

- 22 - 26 mm long, want to stop short of growth plate

- ensure screw heads are buried under cartilage, but not too deep so they still engage fragment

- can microfracture with 1 mm k wire around screws

 

MFC OCD 10MFC OCD 13

 

MFC OCD ORIF 1MFC OCD ORIF 2

 

Lateral femoral condyle

 

Technique

 

Arthroscope in medial portal

Clear fat pad

Ensure can see entire dimensions of OCD

 

LFC 3LFC 4LFC 5LFC 6

 

Instrument and screw from lateral portal

- ensure K wires centered in fragment

- flex and extend knee to place inferior / superior screws

- typically 2 - 3 screws maximum (3.5 mm)

- ensure screw heads are buried under cartilage, but not too deep so they still engage fragment

- can microfracture around screws

 

LFC 7LFC 11LFC 10

Inferior screw                                                                                                        Superior screw

 

Lateral OCD ORIF APLateral OCD ORIF 2