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. 2013 Jan 26;2(1):e41-3.
doi: 10.1016/j.eats.2012.10.008. Print 2013 Feb.

Arthroscopic trans-portal deep medial collateral ligament pie-crusting release

Ehud Atoun  1 , Ronen Debbi, Omri Lubovsky, Andreas Weiler, Eytan Debbi, Ehud Rath
Affiliations

Arthroscopic trans-portal deep medial collateral ligament pie-crusting release

Ehud Atoun et al. Arthrosc Tech. .

Abstract

Arthroscopic treatments of meniscal injuries of the knee are among the most common orthopaedic procedures performed. Adequate visualization of the posterior horn of the medial meniscus might be challenging, especially in patients with tight medial compartments. In these cases instrument manipulation in an attempt to reach the posterior horn of the meniscus can cause an iatrogenic chondral injury because of the narrow medial joint space. A transcutaneous medial collateral ligament (MCL) pie-crusting release facilitates expansion of the medial joint space in a case of a tight medial compartment. Nevertheless, it might cause injury to the superficial MCL, infection, and pain and injury to the saphenous nerve because of multiple needle punctures of the skin. We describe an inside-out, arthroscopic deep MCL pie-crusting release, which allows access to the medial meniscus through the anterior approach to provide good visualization of the footprint and sufficient working space.

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Figures

Fig 1
Fig 1
Typical arthroscopic visualization of medial meniscus in a patient with a narrow medial joint space.
Fig 2
Fig 2
Trans-portal arthroscopic puncturing of posterior-most part of deep MCL.
Fig 3
Fig 3
Typical arthroscopic visualization of medial meniscus after arthroscopic pie crusting.
Fig 4
Fig 4
Ease of access to posterior horn of medial meniscus after pie crusting.
See this image and copyright information in PMC

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