Percutaneous Partial Outside-In Release of Medial Collateral Ligament for Arthroscopic Medial Meniscus Surgery With Tight Medial Compartment by Finding a "Magic Point".

Abstract

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.