Table 1.

Step-by-Step Fresh Osteochondral Tibial Plateau and Meniscal Transplantation

Step	Description
1	With the patient in the supine position, hold the knee at 90° of flexion with the help of a distal foot support and a lateral thigh support
2	An 8 to 10 cm longitudinal medial or anterolateral approach for the medial and lateral tibial plateaus, respectively, is performed
3	An osteotomy is performed using saws and chisels with special care given to resecting the least amount of bone necessary to obtain a flat surface
4	In case of a deeper defect, supplement the void with cancellous or corticocancellous bone autograft from the iliac crest
5	The graft is cut to a 10 mm thickness, matching the prepared recipient area relative to the mediolateral and anterior-posterior measures
6	Vertical sutures are passed all along the meniscal graft every 10 mm
7	Similarly, passing sutures are passed through the capsule every 10 mm at the joint line. They will guide the meniscal sutures to being positioned at the meniscocapsular junction
8	Resect all the unnecessary soft-tissue of the graft and then wash it with a high-pressure pulsatile system
9	The graft is introduced. Fix the osteochondral part of the graft with 2 cancellous screws and the meniscus with its sutures
10	The approach is closed in the usual manner. Intra-articular drainage is recommended