Dr. Garcia’s technique using biocartilage for smaller cartilage defects

In this clip, Dr. Grant H. Garcia demonstrates a cartilage repair technique on the knee known as "microfracture plus" or BioCartilage placement. This procedure targets smaller, localized focal cartilage defects—in this particular case, a small chondral defect on the medial side of the patella (kneecap).

The procedural breakdown includes:

• Lesion Debridement: The surgeon uses a surgical curette to cleanly scrape away and clear out the damaged cartilage down to the calcified cartilage layer. This provides a clean rim and a stable base for the repair material.
• Microfracture: Dr. Garcia uses a thin Kirschner wire (K-wire) to tap tiny holes directly into the exposed bone bed. This intentionally draws out a small amount of blood and native bone marrow stem cells to stimulate localized healing.
• BioCartilage Mixed with PRP: The defect is packed with an allograft BioCartilage construct (dehydrated particulate cartilage matrix) combined with Platelet-Rich Plasma (PRP) harvested from the patient. The paste is smoothed into the hole and receded by about 1 mm below the surrounding cartilage edges to allow for tissue integration and protective in-growth.
• Sealing with Fibrin Glue: The area is thoroughly dried before applying medical fibrin glue directly over the graft site. The glue is left to set and cure undisturbed for roughly five minutes.
• Range of Motion Test: Once cured, the knee is taken through a standard range of motion cycle to verify the stability of the paste and ensure it stays perfectly intact.

Dr. Garcia notes that this particular modern combination technique yields a solid success rate of 80% to 85% for localized cartilage repairs.