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head. Arthroscopically, the patient was noted to have a large OCD, which was unstable to manipulation. The arthroscopic shaver is being used to debride the lesion. Fibrocartilage and friable tissue were noted at the margins and were also debrided to a stable base.

Vascularized Fibular Graft

FIGURE 14.18. Chondromalacia associated with an unstable chondral fracture (F). Following free vascularized fibular grafting to the hip for osteonecrosis, the patient had mechanical symptoms and severe pain with activity. Arthroscopic examination revealed a de-laminating chondral injury and associated chondromalacia. This tissue was debrided, and the patient has been symptom free for more than 4 years. View is from the anterolateral portal. H, head.

FIGURE 14.18. Chondromalacia associated with an unstable chondral fracture (F). Following free vascularized fibular grafting to the hip for osteonecrosis, the patient had mechanical symptoms and severe pain with activity. Arthroscopic examination revealed a de-laminating chondral injury and associated chondromalacia. This tissue was debrided, and the patient has been symptom free for more than 4 years. View is from the anterolateral portal. H, head.

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