Table IV.

Suggested preventative techniques

Distal portal (e.g. MAP, MMAP, DALA)

Clear rim of obstructing capsule and synovium

Pilot hole (microfracture awl)

Zone-specific drilling (see Table V)

Visualize from central compartment during drilling and anchor placement

Listen for change in drill sound

Feel for increase drill resistance if engage subchondral bone

Extra caution at 3 o’clock (direct anterior) rim and/or thin articular cartilage

Rim trimming

Soft (e.g. suture-based) anchors

Small diameter anchors

Short anchors

Increasing radius of curvature of curved anchor systems

MAP, mid-anterior portal, MMAP, modified mid-anterior portal, DALA, distal anterolateral accessory.