Bosco Francesco, Giustra Fortunato, Ghirri Alessandro, Battaglia Domenico Lewis, Capella Marcello, Massè Alessandro
Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy.
Department of Orthopaedics and Traumatology, G.F. Ingrassia Hospital Unit, ASP 6, Palermo, Italy.
Ann Jt. 2024 Feb 22;9:14. doi: 10.21037/aoj-23-54. eCollection 2024.
This study presents a comprehensive surgical technique for performing a 'pie-crust' release of the medial collateral ligament (MCL) to enhance visualization of the medial compartment during arthroscopic knee procedures. The primary objective of this research is to improve the precision of diagnosis and treatment for injuries specifically affecting the posterior horn and posterior root of the medial meniscus. Arthroscopic knee procedures have become increasingly common in orthopedic surgery, offering the advantage of minimally invasive techniques for treating a wide range of knee conditions. However, accessing and visualizing the posterior structures within the medial compartment can be challenging. To overcome this limitation, the surgical technique presented in this study offers a systematic approach that includes patient positioning, precise identification of anatomical landmarks, and a detailed, step-by-step procedural description. The process begins with meticulous marking of anatomical landmarks to provide reference points. Precisely identifying the location for the MCL release is of utmost importance. This involves making needle punctures with guidance from arthroscopic visualization and applying valgus strain to the knee as necessary. One of the key advantages of this described surgical technique is its focus on safety and efficacy. Surgeons can work more confidently and precisely by reducing the risk of iatrogenic cartilage damage and facilitating access to the posterior structures within the medial compartment. Clinical outcomes from this approach have demonstrated consistently favorable results, leading to improved patient recovery and reduced complications. Furthermore, it is noteworthy that the postoperative use of a brace is not mandatory, adding to the appeal of this technique for both patients and surgeons. This surgical technique's enhanced visualization and optimized treatment outcomes make it a valuable tool in the arsenal of orthopedic surgeons specializing in knee arthroscopy. In conclusion, this study's surgical technique has the potential to significantly improve the diagnosis and treatment of patients with meniscal injuries in the medial compartment, ultimately leading to better clinical outcomes and patient satisfaction.
本研究介绍了一种用于在关节镜膝关节手术中对内侧副韧带(MCL)进行“派皮”松解以增强内侧间室可视化的综合手术技术。本研究的主要目的是提高对内侧半月板后角和后根特定损伤的诊断和治疗精度。关节镜膝关节手术在骨科手术中已变得越来越普遍,它具有微创技术的优势,可用于治疗多种膝关节疾病。然而,进入并可视化内侧间室内的后部结构可能具有挑战性。为克服这一局限性,本研究提出的手术技术提供了一种系统方法,包括患者体位摆放、精确识别解剖标志以及详细的分步手术描述。该过程始于对解剖标志进行细致标记以提供参考点。精确确定MCL松解的位置至关重要。这涉及在关节镜可视化引导下进行针刺,并根据需要对膝关节施加外翻应力。所描述的这种手术技术的关键优势之一在于其对安全性和有效性的关注。通过降低医源性软骨损伤的风险并便于进入内侧间室内的后部结构,外科医生能够更自信、精确地操作。这种方法的临床结果一直显示出良好效果,从而改善了患者康复情况并减少了并发症。此外,值得注意的是,术后并非必须使用支具,这增加了该技术对患者和外科医生的吸引力。这种手术技术增强的可视化效果和优化的治疗结果使其成为专门从事膝关节镜检查的骨科医生的宝贵工具。总之,本研究的手术技术有可能显著改善内侧间室半月板损伤患者的诊断和治疗,最终带来更好的临床结果和患者满意度。