The relationship of neural structures to arthroscopic posterior portals according to knee positioning

Ahn, Jin Hwan; Lee, Sang Hak; Jung, Ho Joong; Koo, Kyung Hyo; Kim, Seong Hwan

doi:10.1007/s00167-010-1326-7

Cited by 36 publications

(30 citation statements)

References 31 publications

(57 reference statements)

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“…Since we inject posteromedially at the level of the medial femoral condyle, the popliteal neurovascular bundle, the posterior cruciate ligament, and menisci are not in the field of view and are therefore protected from injury. Ahn et al 8 further cautioned that the branches of the saphenous nerve have a variable pattern over the medial aspect of the knee. Despite the anatomic variability of the saphenous nerve, posteromedial and posterolateral portals are occasionally created during knee arthroscopy for certain indications.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the anatomic variability of the saphenous nerve, posteromedial and posterolateral portals are occasionally created during knee arthroscopy for certain indications. The posteromedial portal is accepted to be within 5 mm of the joint line, just above the medial meniscus and posterior to the medial femoral condyle 8 , 10 . Ogilvie‐Harris et al 11 specifically described the posteromedial arthroscopic portal as a soft spot bounded by the medial head of the gastrocnemius, the semimembranosus tendon, and the medial collateral ligament.…”

Section: Discussionmentioning

confidence: 99%

“…The semitendinosus tendon continues along the posteromedial knee with the sartorius and gracilus muscles to insert on the pes anserinus at the medial tibia 5 . The saphenous neurovascular bundle is also variably located posteromedially 8 …”

mentioning

confidence: 99%

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Sonographically Guided Posteromedial Approach for Intra‐articular Knee Injections

Tresley

Jose

2015

J of Ultrasound Medicine

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Osteoarthritis of the knee can be a debilitating and extremely painful condition. In patients who desire to postpone knee arthroplasty or in those who are not surgical candidates, percutaneous knee injection therapies have the potential to reduce pain and swelling, maintain joint mobility, and minimize disability. Published studies cite poor accuracy of intra-articular knee joint injections without imaging guidance. We present a sonographically guided posteromedial approach to intra-articular knee joint injections with 100% accuracy and no complications in a consecutive series of 67 patients undergoing subsequent computed tomographic or magnetic resonance arthrography. Although many other standard approaches are available, a posteromedial intra-articular technique is particularly useful in patients with a large body habitus and theoretically allows for simultaneous aspiration of Baker cysts with a single sterile preparation and without changing the patient's position. The posteromedial technique described in this paper is not compared or deemed superior to other standard approaches but, rather, is presented as a potentially safe and efficient alternative.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Sonographically Guided Posteromedial Approach for Intra‐articular Knee Injections

Tresley

Jose

2015

J of Ultrasound Medicine

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“…This procedure is technically more challenging and requires good mastery of posterior arthroscopic approaches [30,31] (Fig. 14).…”

Section: Arthroscopic Posterior Arthrolysismentioning

confidence: 99%

Post-traumatic knee stiffness: Surgical techniques

Pujol

Boisrenoult

Beaufils

2015

Orthopaedics & Traumatology: Surgery & Research

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Post-traumatic knee stiffness and loss of range of motion is a common complication of injuries to the knee area. The causes of post-traumatic knee stiffness can be divided into flexion contractures, extension contractures, and combined contractures. Post-traumatic stiffness can be due to the presence of dense intra-articular adhesions and/or fibrotic transformation of peri-articular structures. Various open and arthroscopic surgical treatments are possible. A precise diagnosis and understanding of the pathology is mandatory prior to any surgical treatment. Failure is imminent if all pathologies are not addressed correctly. From a general point of view, a flexion contracture is due to posterior adhesions and/or anterior impingement. On the other hand, extension contractures are due to anterior adhesions and/or posterior impingement. This overview will describe the different modern surgical techniques for treating post-traumatic knee stiffness. Any bony impingements must be treated before soft tissue release is performed. Intra-articular stiff knees with a loss of flexion can be treated by an anterior arthroscopic arthrolysis. Extra-articular pathology causing a flexion contracture can be treated by open or endoscopic quadriceps release. Extension contractures can be treated by arthroscopic or open posterior arthrolysis. Postoperative care (analgesia, rehabilitation) is essential to maintaining the range of motion obtained intra-operatively.

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“…Elle est plus difficile techniquement, et suppose une maîtrise suffisante des voies arthroscopiques postérieures [30,31].…”

Section: Arthrolyse Postérieure Pour Limitation De L'extensionunclassified

Chirurgie mobilisatrice dans les raideurs du genou post-traumatique : techniques chirurgicales

Pujol¹,

Boisrenoult²,

Beaufils³

2014

Conférences d'Enseignement 2014

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The relationship of neural structures to arthroscopic posterior portals according to knee positioning

Cited by 36 publications

References 31 publications

Sonographically Guided Posteromedial Approach for Intra‐articular Knee Injections

Sonographically Guided Posteromedial Approach for Intra‐articular Knee Injections

Post-traumatic knee stiffness: Surgical techniques

Chirurgie mobilisatrice dans les raideurs du genou post-traumatique : techniques chirurgicales

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