Dr. Garcia’s technique for a larger cartilage transplant called a BioUni. This is a great option to save patients knee’s and reduce arthritis.

This video, titled "Dr. Garcia’s technique for a larger cartilage transplant called a BioUni," demonstrates a specialized cartilage transplant method. The BioUni system is used for long, narrow cartilage defects where a standard circular plug is insufficient. It serves as a superior alternative to the "snowman technique" (overlapping two circular plugs), providing a more uniform and preferential structural fit.

Unlike a standard osteochondral autograft/allograft transfer, this unique technique requires harvesting and prepping the donor graft before cutting into the patient's knee.

The procedural steps shown in the video include:

• Donor Graft Preparation: The surgeon performs two overlapping punches on the donor allograft cartilage to trace out an oval shape. A specialized bone saw is used to cut the plug free from the donor bone. A sizing checker is used to verify the thickness and contours of the graft, and a rongeur is used to smooth the edges for a flush, precise fit.
• Recipient Site Evaluation: The surgeon places two central alignment pins (one superior, one inferior) directly into the patient's long cartilage defect, scoring the borders around the pins to match the shape of the oval donor plug.
• Creating the Recipient Socket: Two circular drills equipped with protective depth stops are used over the alignment pins to core out the bone. Because two overlapping circular cuts leave bone fragments in the center, a specialized box cutter and curette are used to clean out the remaining central tissue, creating a smooth, flat oval socket.
• Bone Stimulation: Since this specific patient suffered from osteonecrosis (bone tissue death) in the area, the surgeon drills multiple small 2.0mm holes into the base of the socket to stimulate local blood flow and encourage bone marrow elements to aid healing.
• Dilation and Cleaning: A specialized oval dilator is packed into the socket to ensure a smooth press-fit insertion. The socket is washed via pulse lavage to clear out fat and marrow remnants, and then soaked in Platelet-Rich Plasma (PRP) to augment healing.
• Graft Insertion: A safety suture tape is threaded through the middle of the large donor plug; this allows the surgeon to safely pull the plug back out if it becomes misaligned or stuck during initial insertion. The oval plug is gently tapped into place using a flat impactor rested partially on the patient's intact bone surface, seating it perfectly flush.
• Final Check: The safety suture is pulled out, any tiny overhanging cartilage edges are smoothed with a scalpel, and the knee is put through a physical range of motion to confirm stable tracking and a seamless joint surface.