Chernchujit Bancha, Gajbhiye Komalchand, Wanaprasert Nopporn, Artha Arrisna
Department of Orthopaedics, Thammasat University Hospital, Pathum Thani, Thailand.
Faculty of Medicine, Thammasat University Hospital, Pathum Thani, Thailand.
Arthrosc Tech. 2020 Jun 9;9(7):e935-e940. doi: 10.1016/j.eats.2020.03.009. eCollection 2020 Jul.
The medial meniscus is one of the more commonly injured structures as compared with the lateral meniscus. In patients with tight medial joint space, it is difficult to visualize the posterior horn and posterior root of medial meniscus and even more difficult to use instrumentation for surgical procedures. Normally, the mean medial joint space (4.74 ± 0.75 mm) is less than the mean lateral joint space width (5.63 ± 0.86). Forceful instrumentation in a tight and a narrow medial joint compartment may cause damage to the articular cartilage, which may increase chances of arthritis in future. To increase the opening of the medial compartment after valgus extension stress position of the knee, different techniques of medial collateral ligament release have been described in the literature. However, the majority of articles describe a multiple-puncture method to the medial collateral ligament called the "pie-crusting" method, not explaining the exact point or precise location of release. Here, we describe a simple and reliable method of medial collateral ligament release by finding the exact release point, a "magic point" to increase the medial joint compartment width to facilitate better visualization and instrumentation for surgical procedures.
与外侧半月板相比，内侧半月板是较常受伤的结构之一。在膝关节内侧间隙狭窄的患者中，很难看清内侧半月板的后角和后根，甚至更难以使用手术器械进行手术操作。正常情况下，内侧平均关节间隙（4.74±0.75毫米）小于外侧平均关节间隙宽度（5.63±0.86毫米）。在狭窄的膝关节内侧间室中强行使用器械可能会损伤关节软骨，这可能会增加未来患关节炎的几率。为了在膝关节外翻伸展应力位后增加内侧间室的开口，文献中描述了不同的内侧副韧带松解技术。然而，大多数文章描述的是一种针对内侧副韧带的多点穿刺方法，即“碎皮法”，但没有解释确切的松解点或精确位置。在此，我们描述一种简单可靠的内侧副韧带松解方法，即通过找到确切的松解点，一个“神奇点”，以增加内侧关节间室宽度，便于更好地进行手术可视化和器械操作。
