Basic knee arthroscopy part 3: diagnostic arthroscopy

Abstract

Knee arthroscopy is an important diagnostic and therapeutic tool in the management of disorders of the knee. In a series of 4 articles, the basics of knee arthroscopy are reviewed. In this article (part 3), step-by-step diagnostic arthroscopy is reviewed. Diagnostic arthroscopy is a crucial skill for diagnosing intra-articular disorders of the knee including meniscal, synovial, ligamentous, and articular cartilage pathology. Mastery of the basic diagnostic arthroscopy is a critical tool for orthopaedic surgeons treating disorders of the knee.

Fig 1

Arthroscopic view of the suprapatellar pouch of a right knee from the anterolateral portal. This is the first step in a step-by-step approach to diagnostic arthroscopy. The patella (A) and the trochlear groove (B) can be assessed for chondromalacia.

Fig 2

Arthroscopic view of the medial compartment of a right knee from the anterolateral portal. An arthroscopic probe rests on top of the medial meniscus. Assessment of the medial compartment is step 4 of diagnostic arthroscopy. The medial femoral condyle (A) and medial tibial plateau (C) are assessed for chondromalacia, and the medial meniscus (B) is assessed for tears.

Fig 3

Arthroscopic view of the intercondylar notch of a left knee viewed from the anterolateral portal. The anterior cruciate ligament (A) and posterior cruciate ligament (B), as well as the ligamentum mucosum, are assessed as step 5 of step-by-step diagnostic arthroscopy. The anterior cruciate ligament should be assessed for attachment to the lateral wall.

Fig 4

Arthroscopic view of the lateral compartment of a right knee viewed from the anterolateral portal. Assessment of the lateral compartment is step 6 of diagnostic arthroscopy. The lateral femoral condyle (A) and lateral tibial plateau (C) are assessed for chondromalacia, and the lateral meniscus (B) is assessed for tears.