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SHOULD POSTEROMEDIAL AND POSTEROLATERAL COMPARTMENT VISUALISATION BE A PART OF ROUTINE KNEE ARTHROSCOPY?



Abstract

Background: Arthroscopic visualisation of the postero-medial and posterolateral compartments of the knee through the intercondylar notch using the anterolateral and anteromedial portals respectively is not commonly practiced. The purpose of this study was to prospectively evaluate whether these views are useful either diagnostically, therapeutically or both in a routine knee arthroscopy.

Patients and Methods: It is a prospective study of two hundred consecutive patients who underwent a routine knee arthroscopy in our unit using the standard portals following an appropriate clinical and radiological evaluation. Posteromedial and posterolateral compartment visualisation through the intercondylar notch was undertaken in all the patients. An evaluation of the ease of the technique, the usefulness of visualisation and the morbidity associated with the procedure were recorded.

Results: The technique was deemed simple to perform in 91% of the patients. It was found to be more difficult in knees with degenerative joint disease. Posteromedial and posterolateral compartment visualisation was found to be useful for diagnosis or treatment in 15% and 6% of the diagnosed conditions respectively. The technique was most useful for tears of the posterior horn of the medial meniscus, most of which were not detected by visualisation from the anteromedial compartment alone. Visualisation of the compartments was deemed adequate in 98% of the patients. There was no morbidity associated with this procedure.

Conclusion: We believe that visualisation of the pos-teromedial and posterolateral compartment in a routine knee arthroscopy is beneficial; and an easy and safe procedure to perform.

Correspondence should be addressed to: Tim Wilton, BASK, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.