scholarly journals Percutaneous Partial Outside-In Release of Medial Collateral Ligament for Arthroscopic Medial Meniscus Surgery With Tight Medial Compartment by Finding a “Magic Point”

2020 ◽  
Vol 9 (7) ◽  
pp. e935-e940
Author(s):  
Bancha Chernchujit ◽  
Komalchand Gajbhiye ◽  
Nopporn Wanaprasert ◽  
Arrisna Artha
Keyword(s):  
Medial Collateral Ligament ◽  
Medial Meniscus ◽  
Medial Compartment ◽  
Collateral Ligament ◽  
Meniscus Surgery

Percutaneous medial collateral ligament release is very often useful during arthroscopic medial meniscus surgery

Chirurgia ◽  
2020 ◽  
Vol 33 (2) ◽  
Author(s):  
Nicolae C. Bota ◽  
Sergiu Caterev ◽  
Alexandru Guseila ◽  
Dan V. Nistor
Keyword(s):  
Medial Collateral Ligament ◽  
Medial Meniscus ◽  
Collateral Ligament ◽  
Meniscus Surgery

scholarly journals Needle assisted arthroscopic clysis of the medial collateral ligament of the knee: a simple technique to improve exposure in arthroscopic knee surgery

2013 ◽  
Vol 5 (4) ◽  
pp. 38 ◽  
Author(s):  
Xinning Li ◽  
Ronald M. Selby ◽  
Ashley Newman ◽  
Stephen J. O'Brien
Keyword(s):  
Medial Collateral Ligament ◽  
Tibial Plateau ◽  
Medial Meniscus ◽  
Knee Arthroscopy ◽  
Medial Compartment ◽  
Spinal Needle ◽  
Collateral Ligament ◽  
Valgus Stress ◽  
Posteromedial Corner ◽  
Arthroscopic Knee

During knee arthroscopy, narrowness and tightness maybe encountered in the medial compartment that does not allow sufficient visualization or instrumentation. When this occurs, our team has found it helpful to perform a percutaneous clysis of the deep portion of the medial collateral ligament with a spinal needle. With the knee positioned in 10° to 20° of flexion and a valgus stress is applied. A spinal needle (18 Gauge) is passed percutaneously through the medial collateral ligament between the tibial plateau and undersurface of the medial meniscus. Several passes are made with the spinal needle with the bevel of the needle angled to selectively divide the fibers while keeping the medial collateral ligament under tension. Then with controlled valgus force, the medial compartment will progressively open allowing improved visualization to the posteromedial corner of the knee. This increase in space gives an enhanced visual field and further allows more room for arthroscopic instrumentation.

Pie Crust Technique of the Deep Medial Collateral Ligament in Knee Arthroscopy: Ultrasound and Anatomic Study

2018 ◽  
Vol 32 (08) ◽  
pp. 764-769
Author(s):  
Guillem Claret-Garcia ◽  
Jordi Montañana-Burillo ◽  
Eduard Tornero-Dacasa ◽  
Manel Llusá-Pérez ◽  
Dragos Popescu ◽  
...  
Keyword(s):  
Medial Collateral Ligament ◽  
Statistical Significance ◽  
Mean Value ◽  
Saphenous Nerve ◽  
Medial Compartment ◽  
P Value ◽  
Collateral Ligament ◽  
Anatomical Dissection ◽  
Ultrasound Measurements ◽  
The Mean

AbstractThis article determines compartment opening of the medial articular space of the knee after pie crust (PC) technique of the medial collateral ligament (MCL) by ultrasound measurements and anatomic dissection. This is a cadaveric study of 12 specimens. Four anatomic references were marked on the skin. Distances between the femur and tibia in the internal compartment at 30 degrees of flexion were obtained with ultrasound measurements in four situations: with and without applying valgus force both prior and after the PC technique. Ultrasound measurements of the medial articular compartment were made twice and mean value was calculated. An anatomical dissection was performed and distances between the puncture marks and the infrapatellar branch of the saphenous nerve was measured. Lilliefors test of normality was applied and variables were expressed as mean and standard deviation (SD). Qualitative variables were expressed by absolute frequencies and percentages. Statistical significance was a two-tailed p-value of < 0.05. Prior to the PC technique, mean (SD) distance between the femur and tibia in the medial compartment were 14.2 (4.0) mm in basal conditions and 17.1 (3.7) mm when applying valgus force (p = 0.003). PC technique increased the mean (SD) distance by 1.9 (1.9) mm under basal conditions (p < 0.01) and 2.9 (1.6) mm when applying valgus force (p < 0.01). The infrapatellar branches of the saphenous nerve were not damaged and the mean (SD) distance between the punctures and the nerve was 9.0 (3.3) mm. The PC is a reproducible, safe, and measurable surgical technique that opens controllably the medial compartment. PC as described avoided damage to the nerve branches.

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