Fig 13.

View through a mini-medial parapatellar arthrotomy of the right knee in the supine position. (A) A Paulsen retractor (∗) is placed on the medial aspect of the medial femoral condyle retracting the soft tissues and a bent Hohman retractor (∗∗) is used to retract the patella laterally exposing the medial femoral condyle with inserted superior graft (X) and prepared inferior lesion recipient site (arrow). A metal sizing tamp (Y) is used to confirm the depth of the recipient site. (B) A ruler (Z) is used to confirm the length of the autograft dowel (oval). The authors prefer a minimum combined (cartilage + bone) length of 8-10 mm for adequate graft fixation. (C) A rongeur (W) is used to remove any excess bone from the autograft (oval) to ensure that the cartilage surface of the graft sits flush with the cartilage surface of the surrounding condyle.