On the Cover:
Toward a complete knee repair: ACL reconstruction, high tibial osteotomy, gel-based autologous chondrocyte implantation, and cartilage biopsy site. A 47-year-old farmer was injured in a farm accident that caused a complete ACL tear, a complex medial meniscus tear, and a major chondral piece separating from the medial femoral condyle. On evaluation, it was found that he also had an existing varus deformity of the knee with a required correction angle of 10° using the Fujisawa method. The first stage of surgery involved partial meniscectomy, ACL reconstruction, and cartilage biopsy (4-mm OC cylinder, as per company guidelines). After 1 month, when the chondrocytes were ready for implantation, the second stage surgery was performed to correct the varus deformity with an open-wedge medial HTO and implantation of the cultured chondrocytes using gel-based autologous chondrocyte implantation technique. This was performed using two syringesdone with cells and the other with fibrin glue. The liquid solidifies in 5 to 7 minutes. This image reminds us that multiple simultaneous repairs are possible and may be demanded in the present time. See accompanying video at www.arthroscopyjournal.org
. Courtesy of Deepak Goyal, M.B., M.S., and Binoy Palkhiwala, M.B., M.S.
© 2013 Published by Elsevier Inc. All rights reserved.