All right for the counter dr. Koster's Okay Hello everybody. Thanks for having me. It's a big honor. And yes, I would like to present you maybe a new option for Conroe or osteochondral defects and Yes later on we will debate on it. And this is my case. Actually, it's a it's a real case. So I picked it up It's a 35 years old guy Stefan and he plays tennis and he has this Complaining about medial knee pain in his right knee and these are the images and you see this bone marrow lesion and this insufficient cartilage and He had already an ACT repair 15 months ago and this was his alignment neutral alignment and This is the new option. We can get patient specific mini metal implants and That's how it work you need an MRI scan and you then get an so-called Damage marking process that shows you a good overview over your knee. And in the end in this case resulted Yeah insufficient cartilage repair and this bone marrow edema and this is then the plant implant and these are the drill guides that 3d printed and Come with these guides you you implant this this metal implant. This is basically all you need some hooks and that's all and This is how I decide so you are right in my opinion It should be a middle-aged patient or a revision after failed Biological repair the alignment should be fine and no obesity normal range of motion and the tibial cartilage should be okay In my opinion you could also accept a great to Degeneration if the meniscus is fine and the meniscus should be more or less intact So an arthroscopy normally is helpful and this was the interoperative finding so see the delamination of the cartilage and Then you have this drill guide fixed in with 4k wires and this is Crucial you have to have it in the right position because otherwise you get a Not not right position of your implant and on the right side. You see the implant and it's a little bit underneath the surrounding cartilage the surface has to be a little bit deeper and this is the possibility of x-ray and These are two studies that we conducted in Europe about this implant And it also works with the two implants in two compartments with a so far low revision rate and Yeah, and In the end you can restore your native resurface Surface with it. You have a high accuracy to implant it and so far low revision rate But you have to be careful with the alignment and meniscal and tibial cartilage but in the end Yeah, we have to make sure that we do it in the right way everything we operate. Thank you very much

osteochondral defects

patient-specific mini metal implants

MRI scan

3D printed drill guides

tibial cartilage condition