Konrad Malinowski, M. D. , Ph. D. , Adrian Góralczyk, M. D

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Presentation transcript:

Arthroscopic Complete Posterior Capsulotomy for Knee Flexion Contracture Konrad Malinowski, M.D., Ph.D., Adrian Góralczyk, M.D., Krzysztof Hermanowicz, M.D., Ph.D., Robert F. LaPrade, M.D., Ph.D., Rafał Więcek, M.D., Marcin E. Domżalski, M.D., Ph.D. Arthroscopy Techniques Volume 7, Issue 11, Pages e1135-e1139 (November 2018) DOI: 10.1016/j.eats.2018.07.008 Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 1 Arthroscopic view from anterolateral viewing portal in posteromedial compartment of left knee joint. The posteromedial portal is created with a No. 11 blade in the soft spot between the posterior oblique ligament (POL) and medial edge of the medial head of the gastrocnemius. (MFC, medial femoral condyle; MM, medial meniscus.) Arthroscopy Techniques 2018 7, e1135-e1139DOI: (10.1016/j.eats.2018.07.008) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 2 (A) Arthroscopic view from anteromedial portal to posteromedial compartment in left knee joint. The posteromedial capsule is sectioned with scissors from the medial side to the posterior septum. (B) Arthroscopic view from posteromedial portal showing capsulotomy. (MFC, medial femoral condyle; PCL, posterior cruciate ligament.) Arthroscopy Techniques 2018 7, e1135-e1139DOI: (10.1016/j.eats.2018.07.008) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 3 Arthroscopic view from posteromedial portal in left knee joint. The radiofrequency (RF) probe, introduced through an additional anteromedial parapatellar portal, is used to extend the sectioning of the posteromedial capsule laterally and partially remove the posterior septum. (MFC, medial femoral condyle; PCL, posterior cruciate ligament.) Arthroscopy Techniques 2018 7, e1135-e1139DOI: (10.1016/j.eats.2018.07.008) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 4 Arthroscopic view from anteromedial viewing portal in posterolateral compartment of left knee joint. The posterolateral portal is created in the soft spot between the fibular collateral ligament (FCL) and lateral edge of the lateral head of the gastrocnemius. (LFC, lateral femoral condyle; LM, lateral meniscus.) Arthroscopy Techniques 2018 7, e1135-e1139DOI: (10.1016/j.eats.2018.07.008) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 5 Arthroscopic view from anteromedial viewing portal in posterolateral compartment of left knee joint. Closed scissors, introduced behind the posterolateral capsule, are used to create free space for safe maneuvering. After that, the scissors are used to perform posterolateral capsulotomy. (LFC, lateral femoral condyle; LM, lateral meniscus.) Arthroscopy Techniques 2018 7, e1135-e1139DOI: (10.1016/j.eats.2018.07.008) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 6 Arthroscopic view from anteromedial viewing portal in posterolateral compartment of left knee joint. The radiofrequency (RF) probe, introduced through the posterolateral portal, is used to extend the sectioning of the posterolateral capsule and lateral part of the posterior septum. (LM, lateral meniscus.) Arthroscopy Techniques 2018 7, e1135-e1139DOI: (10.1016/j.eats.2018.07.008) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 7 Arthroscopic view from posteromedial portal in left knee joint. The radiofrequency (RF) probe, introduced through the posterolateral portal, is used to remove the rest of the posterior septum. (PCL, posterior cruciate ligament.) Arthroscopy Techniques 2018 7, e1135-e1139DOI: (10.1016/j.eats.2018.07.008) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 8 Arthroscopic view from posteromedial portal in left knee joint. The radiofrequency probe, introduced through the posterolateral portal, is placed between the central posterior capsule and popliteal fossa connective tissue and used to remove the rest of the posterior capsule. The radiofrequency probe must be directed anteriorly. Arthroscopy Techniques 2018 7, e1135-e1139DOI: (10.1016/j.eats.2018.07.008) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions