The utility medial portal: a new arthroscopic approach to the knee.

Placement of accurate arthroscopic portals is crucial in arthroscopic knee surgery. Unlike the inferolateral portal that is usually used initially in arthroscopic surgery, the utility medial portal allows excellent visualization of both the medial and lateral compartments as well as the patellofemoral articulation and suprapatellar pouch. Other diagnostic advantages include visualization of the anterior horn of the lateral meniscus, access into the posterior compartment of the knee, and visualization of the intercondylar notch. Surgically, this portal is invaluable in lateral meniscal procedures. Specifically, placement of the arthroscope in the utility medial portal allows access to the complete lateral meniscus, including the anterior and posterior horns, for both visualization and instrumentation. This portal is also outstanding for use in patellofemoral surgical procedures. This portal has been used with great success as a standard arthroscopic portal without difficulty, primarily in 550 arthroscopic procedures and secondarily in 240 procedures. This portal is recommended for examination of the knee in all cases except those in which there is a high suspicion of an isolated medial meniscus tear. Also, the portal may be used routinely for surgical visualization and instrumentation due to its flexibility.