Left vs Right Designation
Left/Right Graft Designation: Distal Femur & Patella
Left Distal Femur The medial condyle “curves” to the LEFT from anterior (top) to posterior (bottom) The lateral condyle, when cut, has its cut edge “facing” LEFT Left Distal Femur Right Distal Femur The medial condyle “curves” to the RIGHT from anterior (top) to posterior (bottom) The lateral condyle, when cut, has its cut edge “facing” RIGHT RPopularLeft/Right Graft Designation: Tibial Plateau & Meniscus
Right Tibial Plateau Position the graft with the tibial tuberosity (anterior) facing “up” The lateral meniscus will be on the RIGHT. It is smaller and features a tighter curvature “Lateral is Loopy” The medial meniscus will be found on the left. It will be larger and have a wider curvature compared to the lateral meniscus "Medial = Ear-Shaped" Right Tibial Plateau (https://storage.crisp.chat/users/helpdesk/website/45175be43c538400/right-tibial-plateau-resizeeteho3.pnPopularLeft/Right Graft Designation: Distal Tibia & Talus
Right Distal Tibia Position the graft so that the lateral or “open” side is facing the observer The medial malleolus topography slopes down toward the RIGHT Right Distal Tibia Left Distal Tibia Position the graft so that the lateral or “open” side is facing the observer The medial malleolus topography slopes down toward the LEFT Left Distal Tibia (https://storage.Some readersLeft/Right Graft Designation: Other
Right Femoral Head Position the graft to view the inferior/medial aspect, so that the attachment point of the femoral head ligament is facing "up" and the "inside" of the femoral head neck is facing the observer. Examine the cartilage/bone boundary here. The cartilage should be thinner on the posterior side of the femoral head, or receding toward the RIGHT The femoral head ligament attachment may also be positioned slightly posterior relative to the midline of the graft, or towardFew readers
Measuring
Measuring Technique: Distal Humerus
Distal Humerus Length: Maximum length from cut end to medial trochlea Width: Maximum width across articular surface, taken lateral (capitellum) to medial (trochlea). (https://storage.crisp.chat/users/helpdesk/website/-/4/5/1/7/45175be43c538400/distal-humerus1atnmix.jpg =500x500)Few readersMeasuring Technique: Menisci & Tibial Plateaus
Soft Tissue Measurements Maximum Maximum measurement from the ICT to the outer meniscal margin, medial to lateral. Maximum measurement from anterior to posterior. Maximum measurement from the ICT to the outer meniscal margin, medial to lateral. *Take all measFew readersMeasuring Technique: Ankle Grafts
Distal Tibia Distal Tibia Shaft Length: Maximum length from cut end to distal end, taken from the lateral side of the graft. Distal Tibia Length (articular surface): Maximum length of articular cartilage surface, taken anterior to posterior. Talus Width: Maximum width of the talar dome, taken medial to lateral. Lateral Aspect (https://storage.crisp.chat/users/helpdesk/website/-/4/5/1/7/45175be43c538400/dta-shaft-length5gjs20.jpg =500x483) Inferior Aspect (https://storage.crisp.Few readersMeasuring Technique: Patellae
Patella Patella Length: Maximum length of articular cartilage is measured from the superior to inferior margins of the patellar surface. Total Patella Width: Total maximum width of articular cartilage is measured from the medial to lateral margins of the patellar surface Medial Facet Width: Maximum facet width from medial margin to the central ridge of the patella bone. Lateral Facet Width: Maximum facet width from lateral margin to the central ridge of the patella bone. (httpFew readersMeasuring Technique: Femoral Condyle Width
To ensure accurate and consistent reporting of the Width (W) measurement of femoral condyles, follow these steps: Lateral Condyles Take the W measurement at an acute angle to where the lateral condyle groove intersects with intercondylar fossa (1.) The other component of this angle (your measurement) should be parallel to the coronal plane. Take the W measurement at the cartilage-bone boundary, regardless of cartilage quality at the boundary. Medial Condyles The W meFew readersMeasuring Technique: Trochlear Grafts
Measuring Trochlear Width and Length Trochlear Width: Take the maximum width measurement at the most anterior portion of the trochlea. Trochlea Width (anterior view) Trochlea Width (inferior view) Caliper Position for Trochlear Width (https://storage.crisp.chat/users/helpdesk/website/Few readers
OCA Core Mapping
Femoral Head Attempt the first 4 cores at the North, East, West, and South (NEWS) positions of the femoral head. North: Take the core from the top/superior aspect of the femoral head. With the North core reamed, use a mallet to drive a small Lambotte osteotome into the lateral aspect of the femoral head (!). Aim for the spot in the femoral head so that the osteotome will intersect with the very bottom of the North core. If successful, you should see the North core "pop up", allFew readersWeight-Bearing/High-Utilization Areas & Cartilage Grading
Cartilage Grade Levels Determined by Defect Location Relative to the Weight Bearing or High Utilization Region of a Graft. Grade 1: Pristine cartilage, no defects of that type (minor Rough Areas and striations OK) Grade 2: Defects outside a WB/HU region. Grade 3: Defects inside a WB/HU region. Grade 4: No usable cartilage. Weight Bearing Regions of HemiCondyles *The Weight Bearing Regions begin where the trochlear cut would be made (45° from intercondylar notch) and end atFew readersCMC vs MCP
CMC vs MCP Joints This Job Aid is available to help with identifying hand/wrist grafts that are sent for processing already dissected, and to help guide the dissection for tissue sent as whole hand/wrist en-blocs. Figure 1: Right Hand/Wrist Bones Overview (https://storage.crisp.chat/users/helpdesk/website/45175be43c538400/hand-v3Some readersCartilage Defect Identification
Defect Code 1: Bruising Discolored cartilage due to blood pooling under the tissue. Result of trauma. Look for other signs of trauma on surrounding bone and soft tissue. Affected area is typically faint/light red in color. Deeper, more severe bruises will be darker in color (crimson, purple). Superficial Bruising Deeper Bruising (https://storage.crisp.chat/users/helpdesk/websSome readersPatella Wiberg Classification
The Wiberg Scale is used to describe the shape and size of the medial and lateral facets of a patella. The shape of any patella's facets can be described in one of three ways: Concave: Having a surface that curves inward, like the interior of a circle or sphere. Convex: Having a surface that curves outward, like the exterior of a circle or sphere. Flat: A level, even surface absent of curvature. IMPORTANT: When determining where on the Wiberg scale a patella belongs, the facet cuPopular