Bursal Endoscopy

A risk–benefit analysis of alternating low-pressure CO2 insufflation and fluid medium in arthroscopic knee ACL reconstruction

“…Although many authors agree with the advantages of gas over fluid in terms of quality of vision and technical comfort [5, 8, 10, 11, 13, 18, 19, 22, 23], we have no objective means to quantify the potential advantages of improved visualization.…”

“…Adequate visualization of joint structures is usually achieved, although obscurations by the mobilization of the synovial villi, haemorrhage and detached particles during ACL reconstruction may cause additional surgical difficulty. An alternative to minimize this inconvenience is to use a gas to distend the joint [22], which remains a very rare practice among orthopaedic surgeons. However, since the 1980s, authors who compared gas and fluid arthroscopy realized the superiority of gas, providing more realistic visualization (Fig.…”

“…2) and avoiding reduced vision due to bleeding, synovial villi and floating debris (Fig. 3) [5, 8, 10, 11, 13, 18, 19, 22, 23]. For Henche [8]: “The advantage of gas filling lies in the natural appearance of the interior of the knee joint.…”

“…For Henche [8]: “The advantage of gas filling lies in the natural appearance of the interior of the knee joint. There is always a clear view, and if bleeding of the synovial membrane occurs it does not blur the image.” At the same time, for Eriksson and Sebik [5], advantages of gas medium are “improved clarity and the ability to make a more realistic assessment of joint surface pathology” and for Johnson [11] an “increase field of vision.” More recently, Strobel [22] mentioned “good visibility, good depth of field and does not disturb the synovial villi” to describe gas advantages in a rigorous comparison between gas and fluid arthroscopy (Fig. 1).…”

Knee Injuries in the Elite American Football Player: A Descriptive Pictorial Imaging and Mechanism of Injury Review

“…Recent interest has also been brought to tears of the posterior horn of the medial meniscus at the meniscocapsular junction in patients with anterior cruciate ligament (ACL)–deficient knees, otherwise known as ramp lesions 14 . These lesions have a reported incidence as high as 40% in patients with concomitant ACL tears, as the medial meniscus plays a significant role in the prevention of anterior tibial translation in the setting of ACL deficiency 15,16 .…”