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Updated: Jun 8, 2026
Autologous Microfractured and Purified Adipose Tissue for Arthroscopic Management of Osteochondral Lesions of the Talus
Published on: January 23, 2018
Fluoro-Free navigated retrograde drilling of osteochondral lesions
Florian Gras1, Ivan Marintschev, David M Kahler
1Department of Trauma Surgery, Hand Surgery and Reconstructive Surgery, Friedrich Schiller University, Jena, Erlanger Allee 101, 07740 Jena, Germany. marc.gras@med.uni-jena.de
Purpose:
Retrograde drilling of osteochondral lesions (OCLs) is a recommended, but demanding operative approach for revascularization of lesions in stage 1-3 according to Berndt and Harty after failed conservative treatment. The gold standard of intraoperative driller guidance is fluoroscopic control. Limitations are a 2D visualization of a 3D procedure and sometimes limited view of the OCL in fluoroscopy, leading to increased radiation exposure. A new image-free navigation procedure was evaluated for practicability and precision in first clinical applications.
Methods:
In a period of 7 months, retrograde drillings were performed in eight patients (3x femoral condyle, 5x talus) using the new Fluoro-Free navigation procedure without rigidly fixed reference bases.
Results:
In total, 29 retrograde drillings were performed without any technical problem. The overall mean operating time was 82.1 ± 29.3 min (34.6 ± 6.4 min for the standard arthroscopy and 11.2 ± 1.2 min per drill). Twenty-seven of 29 drillings hit the target with a 100% first-pass accuracy. Two complications during drilling (one navigation specific and one navigation independent) were observed.
Conclusion:
The paper describes the promising first clinical applications of a new Fluoro-Free navigation procedure for the retrograde drilling of OCLs determined by arthroscopy. The benefit of that navigated drillings with a high rate of first-pass accuracy and no need for radiation exposure in contrast to standard techniques is highlighted.
