I am stumped on this one if anyone has any ideas I would greatly appreciate it. Here is the body of the op note " medial-sided arthrotomy incision. The medial portal site was extended proximally for about 10cm to better expose the undersurface of the patella. The patellar defect was approximately 2x1cm. The edges were debrided back to a further stable rim. The loose bodies were removed from the joint space itself. There was 1 irregularly-shaped, nonviable, cartilaginous loose body, but the major fragment was approximately 2x1cm. This was contoured gently, and then pre-drilled as was the donor site, and incision was made fix this osteochondral fragment back down to the patella. This did fit nicely into the donor site, and it was provisionally fixed with a k-wire. This was followed by definitive fixation with a conmed 1.5mm smart nails. All 4 had excellent pruchase. All 4 countersunk. This resulted in a very nicely contoured patellar fragment, which was fully examined, and a small amt. of overhang distally was gently debrided." It does state the "patellar osteochondral fracture that was fixated appeared to engage the trochlea at about 15 to 20 degrees."
So maybe 27524?