Fig. 9-A.

Microsuturing should start at the central portion of the sulcus proximally and distally in an alternating medial and lateral pattern to restore the concavity to the trochlea, as shown by the numbers indicating the sequence of the sutures. (Reproduced, with permission of Elsevier, from: Minas T. A primer in cartilage repair and joint preservation of the knee. Expert consult. Philadelphia: Elsevier Saunders; 2011.)

Fig. 9-B.

When microsuturing the membrane over a large trochlear defect across the midline sulcus, it is important to oversize the membrane in a medial-to-lateral direction. Suturing in a proximal-to-distal direction starting at the midline of the sulcus and working laterally and medially allows restoration of the concavity of the sulcus without undue tension on the membrane and an even depth throughout the entirety of the cartilage defect. (Reproduced, with permission of Elsevier, from: Minas T. A primer in cartilage repair and joint preservation of the knee. Expert consult. Philadelphia: Elsevier Saunders; 2011.)