Knee Surgery

Indication: Complete ACL tear causing rotatory or translational knee instability.

Technique: Anatomic keyhole tunnel placement and graft fixation restoring native knee biomechanics.

Indication: Re-rupture or graft failure following previous ACL surgery.

Technique: Evaluation of prior tunnel position, bone loss, biological graft selection, and multi-stage bone grafting if needed.

Indication: Acute proximal femoral avulsion tears with excellent remnant tissue within 2-3 weeks.

Technique: Primary suture anchor reattachment with internal brace reinforcement.

Indication: Standard primary ACL reconstruction in active individuals.

Technique: Quadrupled semitendinosus and gracilis autograft with cortical button fixation.

Indication: High-level pivoting, collision, or professional athletes demanding maximum stiffness.

Technique: Bone-to-bone healing within femoral and tibial tunnels for robust early incorporation.

Indication: Modern high-strength graft with excellent cross-sectional area and minimal donor-site morbidity.

Technique: All-inside or full-thickness autograft with or without bone block.

Indication: Anatomical replacement of the dominant anteromedial bundle.

Technique: Single femoral and tibial tunnel positioned precisely in the native footprint.

Indication: Recreating both the anteromedial and posterolateral bundles in selected anatomy.

Technique: Four anatomical tunnels replicating native rotational and translational restraint.

Indication: Grade III PCL tears or symptomatic chronic posterior sag.

Technique: Transtibial or tibial inlay reconstruction using high-strength autograft or allograft.

Indication: Recurrent posterior laxity following failed PCL reconstruction.

Technique: Correction of posterior tibial slope, revision graft placement, and tunnel management.

Indication: High-energy bicruciate ligament tears and knee dislocations.

Technique: Simultaneous anatomic reconstruction balancing tension and graft isometry.

Indication: High-risk athletes, revision cases, hyperlaxity, or high-grade pivot shift.

Technique: Modified Lemaire tenodesis adding a lateral restraint to protect the intra-articular ACL graft.

Indication: Associated anterolateral rotatory instability (ALRI) or Segond fracture.

Technique: Anatomical reconstruction of the ALL running from lateral epicondyle to proximal tibia.

Indication: Acute Grade III MCL femoral or tibial bony avulsions.

Technique: Primary suture anchor repair and ligament augmentation.

Indication: Chronic valgus opening or midsubstance Grade III tears.

Technique: Anatomic reconstruction restoring both the superficial MCL and posterior oblique ligament (POL).

Indication: Traumatic varus instability and lateral knee disruption.

Technique: Anatomic fibular head to lateral femoral epicondyle graft reconstruction.

Indication: Combined injury to LCL, popliteus tendon, and popliteofibular ligament.

Technique: LaPrade anatomical reconstruction restoring varus and external rotatory stability.

Indication: Severe contact knee injury with persistent valgus and rotational instability.

Technique: Single-stage coordinated reconstruction preventing graft overload.

Indication: Combined rotatory and hyperextension instability.

Technique: Simultaneous ACL and anatomic PLC reconstruction to protect the ACL from catastrophic varus stress.

Indication: Severe hyperextension and external rotation trauma.

Technique: Coordinated posterior and posterolateral reconstructive stabilization.

Indication: Two or more ligaments torn (KD I - KD IV classification).

Technique: Comprehensive, staged or single-stage reconstruction restoring global joint congruity.

Indication: High-energy trauma with gross tibiofemoral dislocation requiring emergency reduction.

Technique: Vascular assessment followed by anatomical multiligamentous repair and reconstruction.

Indication: Recurrent instability following complex prior trauma.

Technique: Staged osteotomy, tunnel management, and revision autograft/allograft reconstruction.

Indication: Vertical longitudinal tears in the vascular red-red or red-white zone.

Technique: Suture repair preserving native shock-absorbing fibrocartilage.

Indication: Tears of the highly mobile lateral meniscus in young active patients.

Technique: Targeted suture fixation with protection of the popliteus tendon and peroneal nerve.

Indication: Posterior horn and body tears accessible via keyhole instrumentation.

Technique: Low-profile peek/suture anchor devices placed entirely through arthroscopic portals.

Indication: Middle third and anterior horn tears requiring robust vertical mattress sutures.

Technique: Cannula guidance from inside the joint with safe mini-incision retrieval on the capsule.

Indication: Anterior horn tears.

Technique: Needle guidance from outside the skin into the joint for precise suture tying.

Indication: Root avulsions causing meniscus extrusion and rapid bone-on-bone arthritis.

Technique: Transtibial pull-out suture technique reattaching the root footprint to bleeding bone.

Indication: Root tears commonly associated with acute ACL ruptures.

Technique: Anatomical transtibial suture anchor fixation into the tibial plateau.

Indication: Radial splits disrupting circumferential hoop stresses.

Technique: Two-plane cross-stitch and horizontal mattress suture repair.

Indication: Hidden meniscocapsular separations in the posteromedial corner associated with ACL tears.

Technique: Posteromedial portal visualization and direct capsulomeniscal repair.

Indication: Delaminating tears in active individuals, often with parameniscal cysts.

Technique: Cyst decompression and stacked vertical mattress suture repair.

Indication: Irreparable, complex, degenerate, or macerated tears in the avascular white-white zone.

Technique: Minimal resection trimming only the unstable leaf, preserving the stable peripheral rim.

Indication: Congenitally enlarged, thick discoid meniscus that tears or snaps in children and adolescents.

Technique: Reshaping the meniscus into a normal crescent profile combined with peripheral stabilization.

Indication: Young patients with prior total meniscectomy and unicompartmental joint-line pain without severe arthritis.

Technique: Cryopreserved donor meniscal allograft transplantation with bone plugs or bridge.

Indication: Extruded meniscus causing loss of joint cushioning.

Technique: Suture anchor fixation pulling the extruded meniscus body back onto the tibial plateau rim.

Indication: Recurrent patellar dislocations after rupture of the primary medial checkrein.

Technique: Anatomical reconstruction using a gracilis autograft anchored to the patella and femoral Schöttle's point.

Indication: Patellar maltracking, elevated TT-TG distance (>20mm), patella alta, or lateral facet arthritis.

Technique: Fulkerson or Elmslie-Trillat realignment: medializing, anteriorizing, or distalizing the tibial tubercle with screw fixation.

Indication: Lateral patellar tilt and mild subluxation.

Technique: Combined lateral retinacular lengthening and medial capsular reefing.

Indication: Severe high-grade trochlear dysplasia (flat or domed groove) causing persistent instability.

Technique: Deepening the femoral groove to create a stable bony valley for the patella.

Indication: Patellar dislocation co-existing with significant bony malalignment.

Technique: Simultaneous soft tissue ligament reconstruction and bony realignment.

Indication: Shearing osteochondral fractures off the patella or lateral femoral condyle.

Technique: Bioabsorbable pin or headless compression screw fixation of the cartilage-bone fragment.

Indication: Persistent dislocation or pain following failed previous stabilization.

Technique: CT-based 3D assessment of coronal/torsional alignment and revision MPFL/TTO surgery.

Indication: Superficial cartilage fraying causing mechanical irritation.

Technique: Gentle radiofrequency and mechanical smoothing of unstable cartilage edges.

Indication: Small (<1.5 cm²) full-thickness cartilage defects in low-demand patients.

Technique: Puncturing the subchondral bone plate with awls to recruit bone marrow stem cells and fibrocartilage healing.

Indication: Focal full-thickness cartilage defects (1-2.5 cm²) in active individuals.

Technique: Harvesting cylindrical bone-cartilage plugs from low-weight-bearing knee zones and transferring them into the defect.

Indication: Large cartilage defects (>2.5 cm²) or avascular necrosis.

Technique: Fresh cadaveric donor bone-cartilage core transplantation providing mature hyaline cartilage.

Indication: Large symptomatic cartilage defects requiring true hyaline-like repair.

Technique: Autologous chondrocyte implantation (ACI/MACI) or bone-marrow aspirate concentrate (BMAC) scaffolding.

Indication: Unstable or separated OCD fragments in adolescents and young adults.

Technique: Subchondral drilling and bioabsorbable pin or headless screw fixation.

Indication: Detached cartilage fragments causing locking.

Technique: Keyhole retrieval under continuous fluid lavage.

Indication: Co-existing cartilage defect and meniscal tear.

Technique: Simultaneous meniscal repair and biologic cartilage matrix restoration.

Indication: Isolated medial compartment osteoarthritis in active patients with bowleg (varus) alignment.

Technique: Medial opening-wedge or lateral closing-wedge osteotomy of the tibia fixed with a rigid locking plate, shifting load to the healthy lateral compartment.

Indication: Isolated lateral compartment osteoarthritis with knock-knee (valgus) alignment.

Technique: Opening or closing wedge osteotomy of the distal femur secured with a specialized plate.

Indication: Multi-apical or post-traumatic angular deformities.

Technique: Precision computer-planned corrective bone cuts to restore a neutral mechanical axis.

Indication: Chronic ACL or PCL deficiency co-existing with severe varus/valgus alignment.

Technique: Simultaneous bone realignment to normalize slope and joint load, protecting the ligament graft.

Indication: Medial meniscus root tear in an overloaded varus knee.

Technique: HTO realignment combined with arthroscopic root repair to optimize biological healing.

Indication: Focal cartilage defect located in the overloaded compartment.

Technique: Offloading osteotomy paired with OATS or cell-based cartilage grafting.

Indication: Complete traumatic rupture of the patellar tendon (inability to extend the knee or perform a straight leg raise).

Technique: Transosseous suture tunnels or high-strength suture anchors reinforced with non-absorbable internal bracing.

Indication: Avulsion of the quadriceps tendon off the superior pole of the patella.

Technique: Anatomical transosseous suture repair restoring continuity of the knee extensor mechanism.

Indication: Neglected, retracted, or failed previous tendon repairs.

Technique: Allograft extensor mechanism reconstruction (Achilles allograft or whole extensor mechanism graft).

Indication: Poor tendon tissue quality or re-rupture.

Technique: Synthetic mesh or autogenous semitendinosus augmentation.

Indication: End-stage tricompartmental osteoarthritis, severe pain, stiffness, and bone-on-bone joint loss.

Technique: Precision resurfacing of the femoral condyles, tibial plateau, and patella with biocompatible cobalt-chromium/titanium implants and ultra-high-molecular-weight polyethylene.

Indication: End-stage osteoarthritis strictly confined to the medial or lateral compartment with intact cruciate ligaments.

Technique: Resurfacing only the damaged compartment, preserving all native ligaments, normal kinematics, and offering faster recovery.

Indication: Implant loosening, polyethylene wear, instability, periprosthetic infection, or fracture.

Technique: Extraction of failed implants, reconstructive sleeves/cones for bone loss, and semi-constrained or hinged revision implants.

Indication: Complex secondary osteoarthritis following tibial plateau or distal femoral fractures.

Technique: Hardware removal, deformity correction, and customized joint replacement.