FRCS Trauma & Orthopaedic Surgery

24/12/2025

https://www.facebook.com/share/1FsuJ3998t/

12/12/2025

I present a case of MFC OCD, treated with Arthroscopic OsteoCartilage plug Autograft Transplant (OATS) (12mm plug) from the non-weight-bearing area of the lateral trochlea, using the Arthrex OATS 2.0 kit.

The new kit is advanced on previous one as there is only one blue Tube, used for harvesting the plug and then transplanting it via application of a plastic tube at the end and screwing the white cap to advance it into the defect. It comes with 8mm and 13mm depth core reamers.
In this case, I used a 12mm wide and 8mm deep core drill.

Osteochondritis Dessicans (OCD- the term coined by Franz König in 1887) is most commonly localised to the lateral border of the Medial Femoral condyle, and it is one of the causes of chronic knee pain in children and young adults. The underlying pathology is centred at the osteochondral junction, resulting in an unstable and sometimes a separated subchondral fragment with disruption of the overlying cartilage (Ganley,2025).

The condition commonly presents insidiously as vague knee pain but may advance to overt mechanical symptoms due to loose body formation in the joint, hence presentation with mechanical symptoms (clicking, clunking, locking and local fat pad and anterior horn medial meniscus irritation), like in this case.

How OCDs develop is unknown; one potential unifying theory involves Ribbing’s theory of secondary centres of ossification, which were shown to occur in the classic OCD location on the medial femoral condyle and may be due to a nidus that later develops into an overt OCD lesion through trauma (Shea, 2019).
The ROCK Arthroscopic classification (Carey,2016) describes six groups of OCDs (3 immobile and 3 mobile):

Immobile Lesions (Stable)
1. Cue Ball: No visible abnormality/ very subtle change.
2. Shadow: Intact cartilage with subtle demarcation from the bone.
3. Wrinkle in the Rug: Demarcated cartilage with a fissure, buckle, or wrinkle but still stable.

Mobile Lesions (Unstable)
4. Locked Door: Fissuring at the periphery, but the fragment can't hinge open.
5. Trap Door: Fissuring allows the fragment to hinge open.
6. Crater: The fragment is completely detached, leaving an exposed bone defect.

23/06/2023

New developments in Medial Meniscotibial ligament (Deep MCL) repair

George A. Paletta Jr, MD, MBA, (St. Louis, MO) demonstrates a medial meniscotibial ligament repair using the medial knee capsule repair implant system and GAP™ (Guided Arthroscopic Placement) guide.

27/01/2023

Ramp lesions- arw we missing these...

New Dr. LaPrade Study!

Over One-Third of Patients With Multiligament Knee Injuries and an Intact ACL: Ramp Lesions.

"Over one-third of MLKI patients with an intact ACL were diagnosed with MMRLs on MRI in this series. PMTP bone bruising was observed in 66.7% of patients with MMRLs, suggesting that increased vigilance for identifying MMRLs at the time of ligament reconstruction should be practiced in patients with this bone bruising pattern."

You can read the full study here: https://drrobertlaprademd.com/over-one-third-of-patients-with-multiligament-knee-injuries-and-an-intact-acl-ramp-lesions/

08/09/2022

Queen Elizabeth II dies on 8 Sep

20/06/2022

I am planning to run an online Basic Ortho and Trauma Biomechanics course day. Please comment below if interested and any suggestions.

20/06/2022

Basic Biomechanics- Principles Course (Trauma and Orthopaedics)
18 June 2022

20/06/2022

BBiO
A very successful and well received basic ortho and trauma biomechanics principles course with great feedback.

It is run on a Saturday twice a year where we teach basic biomechanics principles behind routine trauma and arthroplasty scenarios like what 'creep' is, how cement works, how Locking and DCP plates work and principles of lag screw DHS and Nailing. Keep an eye on the advert..

20/06/2022

BBiO
Another successfully conducted Basic Biomechanics Principles Orthopaedics course, Manchester UK.
It is run twice a year, a very well received course with great feedback. We teach basic biomechanics principles of routine Trauma and arthroplasty like what Creep is, how cement works, how DCP and Locking plates work and principles behind DHS and IM Nailing.

21/05/2022

Surgical Anatomy of the Radial Nerve at the Dorsal Region of the Humerus - A Cadaveric Study

http://ow.ly/Vo6O50JcCV8

29/01/2021

In this video, Dr. LaPrade reviews how to read knee MRI of radial meniscus tear. It is important to be able to differentiate a radial meniscus tear on magnetic imaging because they are a lot different from other tears. In a younger patient a radial tear can be catastrophic because it completely destabilizes the meniscus. https://www.youtube.com/watch?v=q5f_87SrYsA&feature=emb_title

25/01/2021

Meniscal root tears-- untreated lead to rapid osteoarthritis.

NEW Dr. LaPrade Study! Meniscal Root Tears: Solving the Silent Epidemic.

In this review article, Dr. LaPrade and his colleagues describe the most current knowledge surrounding meniscal root tears with a primary focus on diagnosis, management, and implications for the health of the knee joint. Historically overlooked or treated with meniscectomy, meniscal root tears are now known to disrupt the biomechanical role of the meniscus in the joint, leading to the rapid development of knee osteoarthritis. Tears of the medial and lateral posterior meniscal roots are associated with differing etiologies and sequelae, especially in regard to their action as secondary stabilizers of the knee, making root tears an important consideration in ligament reconstruction surgery. They discuss diagnostic challenges and well-established hallmarks of meniscus tears on imaging, and will conclude by explaining the preferred method for surgical repair of the meniscal roots and appropriate rehabilitation. https://drrobertlaprademd.com/meniscal-root-tears-solving-the-silent-epidemic/