Arthroscopic assessment of the posterior compartments of the knee via the intercondylar notch: the arthroscopist's field of view

Abstract

This study was undertaken to assess the adequacy of visualization, limits of arthroscopic field of view (FOV), and potential "blind spots" at the periphery of the meniscocapsular junction using standard arthroscopic instrumentation. Five human cadaveric knees were assessed arthroscopically via standard anteromedial and anterolateral portal. Access to the posterior compartments was obtained via the intercondylar notch. FOV was maximized with first a 30 degrees and then a 70 degrees arthroscope, and the farthest point of visualization was marked with a holmium:yttrium-aluminum-garnet (YAG) laser. FOV was calculated as a percentage of the total meniscocapsular periphery. For the lateral compartment, FOV averaged 100.2% with the 30 degrees versus 116.6% with the 70 degrees arthroscope. In all knees, the entire periphery of the lateral meniscocapsular junction could be visualized with the 30 degrees arthroscope anteriorly combined with the 70 degrees arthroscope posteriorly. Medially, FOV averaged 68.9% with a 30 degrees and 88.1% with a 70 degrees arthroscope. A "blind spot" was present in all knees, averaging 21.5% of the meniscocapsular periphery with a 30 degrees arthroscope anteriorly and a 70 degrees arthroscope posteriorly.