Download Arthroscopy of the Knee Joint by Hans-Rudolf Henche Dr. med. (auth.) PDF

By Hans-Rudolf Henche Dr. med. (auth.)

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Extra info for Arthroscopy of the Knee Joint

Example text

Examination of the joint is seldom possible when the flexion exceeds 50-60°, since the infrapatellar fat pad begins to obstruct the view and it is no longer possible to maintain an adequate distance between the end of the optical system and the joint (Figs. 33 and 34). The femoropatellar joint also includes the alar folds. These are the connective tissue septa which pass laterally from the infrapatellar fat pad to the joint capsule and which, in the non-inflated knee joint, lie like menisci in the distal femoropatellar joint.

E. is not reddened) it can be assumed that the structure in question is a thick transverse ligament. The arthroscope is now inserted further in the direction of the medial joint space. In this manner one can follow the meniscus around half the circumference. It is advisable to turn the instrument initially so as to look down on the meniscus. If the ligaments of the knee joint are intact it is necessary to place the lower leg in marked external rotation and, if possible, valgus in order to obtain a view of the medial meniscus around the whole of the circumference.

Two-thirds of the anterior cruciate ligament are visible. The medial part of the joint cannot be fully inspected, especially with the thicker types of arthroscope. The rounded part of the medial femoral condyle obstructs the view of the junction between the circumference and the posterior horn of the medial meniscus. The posterior horn itself can be satisfactorily examined in many cases (in the absence of severe synovitis). The medial approach is particularly suitable for thorough examination of the lateral part of the joint.

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