1. Microdrilling Surgery Augmented With Intra-articular Bone Marrow Aspirate Concentrate, Platelet-Rich Plasma, and Hyaluronic Acid: A Technique for Cartilage Repair in the Knee 
Joseph E. Broyles, M.D., M. Adaire O'Brien, M.P.H., M. Patrick Stagg, M.D. 
Arthroscopy Techniques 
Volume 6, Issue 1, Pages e201-e206 (February 2017)
DOI: /j.eats
Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

2. Fig 1
Bone marrow aspiration and filtration. (A) With the patient positioned lateral, a 15-gauge Illinois bone marrow needle with the lower sleeve removed is inserted into the central posterior superior iliac spine. Fifteen to twenty milliliters of bone marrow is drawn into a 20-mL syringe prefilled with 100 U of heparin. (B) The syringe is capped with an 18-gauge needle, and the bone marrow–heparin mixture is injected through a coupler into a 150-mL polyvinyl chloride transfer bag. (C) The contents are run through a 210-μm filter to remove any bony particulates. (D) The filtered bone marrow is divided between two 10-mL red-top serum tubes.
Arthroscopy Techniques 2017 6, e201-e206DOI: ( /j.eats )
Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

3. Fig 2
Bone marrow aspirate concentrate (BMAC) and platelet-rich plasma (PRP) preparation. (A) The red-top tubes containing the filtered bone marrow are centrifuged for 10 minutes at 1,300g. (B) After centrifugation, the tubes are carefully uncapped, and a spinal needle is used to aspirate the buffy coat and some plasma from both tubes, yielding 3 to 5 mL of BMAC. (C) The Biomet GPS III system is used to obtain 7 mL of PRP from 55 mL of whole blood. (D) The 3 biologic components, ready to be combined for a knee injection: 25 mg of hyaluronic acid (HA), PRP, and BMAC.
Arthroscopy Techniques 2017 6, e201-e206DOI: ( /j.eats )
Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

4. Fig 3
Surgical preparation. (A) Patient positioning for microdrilling surgery. The foot of the operating room bed is dropped down 90°. The contralateral leg is fully abducted on an arm board attached to the end of the bed. (B) A Smith & Nephew 2.9-mm mini burr is modified for drilling holes 2 mm in diameter and 7 mm deep. Seven millimeters of the protective sleeve is removed with a wire cutter to allow the burr to drill to the appropriate depth.
Arthroscopy Techniques 2017 6, e201-e206DOI: ( /j.eats )
Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

5. Fig 4
Trochlea lesion in a right knee, with arthroscopic views from the anterolateral portal. (A) Lesion after debridement and drilling. The holes are 7 mm deep and placed 2 to 3 mm apart. (B) The same lesion is injected with bone marrow aspirate concentrate, platelet-rich plasma, and hyaluronic acid with an 18-gauge 3.5-inch spinal needle under arthroscopic guidance.
Arthroscopy Techniques 2017 6, e201-e206DOI: ( /j.eats )
Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

6. Fig 5
Microdrilling surgical technique for a medial patella facet lesion in a right knee. All arthroscopic views are from the superomedial portal with a 30° arthroscope. (A) A ring curette is used to debride the lesion and to remove the calcified cartilage layer. The curette enters the knee posteromedial to the patella. (B) Drilling of debrided lesion. Tilting the patella with a tenaculum clamp facilitates perpendicular drilling of the patella. (C) A mini shaver is used to smooth the edges of the lesion after drilling.
Arthroscopy Techniques 2017 6, e201-e206DOI: ( /j.eats )
Copyright © 2016 Arthroscopy Association of North America Terms and Conditions