Orthopaedic Jobs

Arthroscopic Visualization of Lateral Compartment



- Lateral Compartment:
    - lateral compartmet may be visualized with the arthroscope thru either anterolateral or anteromedial compartment;
    - initially knee should be placed in flexion and internal rotation, and while holding internal rotation, apply a varus stress, and bring the leg to between 20-40 deg of extension;
          - gentle titrate flexion to maximize visualization;
          - note that the application of varus stress tends to externally rotate the knee which closes down the lateral compartment;
                 - hence, internal rotation is essential to optimize visualization;
    - when the anterolateral portal is used, the arthroscope's entrance is immediately over the anterior horn of the lateral meniscus adjacent to intercondylar notch;
    - anterior and middle thirds of lateral meniscus usually are not problem;
    - if this is a problem, then switch portals;
    - in difficult cases, an assitant can ballott both the medial and lateral menisci which can facilitate visualization and menisectomy;
          - if an assistant is not available a spinal needle can be inserted into the posteror medial aspect of the joint to hold the meniscus in a anterior position;

- Posterolateral Compartment:
    - structures viewed in the posterolateral compartment are the posterior horn of the lateral meniscus, the meniscosynovial capsular reflection, the popliteus tendon, the posterior limits of the popliteus hiatus, the confines of the posterolateral synovial and capsular compartments, and the posterior articular surface of the lateral femoral condyle;
    - occassionally the arthroscope can be passed from the anterolateral portal, but usually passage must come from the anteromedial portal



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Thursday, September 13, 2012 3:45 pm