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

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

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Extra info for Arthroscopy of the Knee Joint

Sample text

The upper third and its attachment to the femur are concealed behind the lateral femoral condyle. With the knee joint flexed at a right angle the assistant now attempts to elicit the anterior drawer sign. In this manner the shape and function of the anterior cruciate ligament can be identified and assessed. Following inspection of the anterior cruciate ligament the inside of the medial femoral con- dyle is systematically examined. It is covered by the synovial membrane. Only in rare cases is the attachment of the posterior cruciate ligament easily recognizable.

Great care should be taken to prevent shreds of the self-adhesive plastic film which is applied to the knee joint from being pulled into the incision by the outer tube of the instrument. This is best avoided by continually rotating the outer tube during insertion. On pushing the trocar into the joint there is a sudden drop in resistance as its tip pierces the joint capsule. On no account should the sharp trocar be allowed to enter the joint space itself since it may easily injure the articular cartilage.

The instrument is then withdrawn slightly so as to reveal the anterior horn of the lateral meniscus, where further fluid is sucked off. The suprapatellar recess is emptied by pressing on it with the hand. By pressing on the back of the knee one can also try to express any remaining fluid from the posterior joint space into the anterior part of the joint, where it can be sucked off. Almost all the irrigation fluid can be evacuated from the knee joint in this manner. Small "puddles" do not compromise the investigation to any serious degree.

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