The pie-crusting technique in knee surgery: Indications, technique, complications and outcomes.

Şahbat, Yavuz; Akçaalan, Serhat; Güzel, Aybars; Turan, Kaya; Gürsoy, Safa · J Exp Orthop · 2026

expert_opinion · Level V

Where this comes from

Abstract

Pie-crusting represents a simple and widely utilised technique for controlled medial soft-tissue release across various knee procedures. When applied in a gradual and indication-driven manner, it can improve visualisation, facilitate instrumentation and reduce the risk of iatrogenic cartilage injury without causing clinically significant instability in most cases. However, the role of pie-crusting differs among surgical contexts, including meniscal repair, periarticular osteotomy and knee arthroplasty, and should be tailored to procedure-specific goals rather than applied routinely. <b>Level of Evidence:</b> Level V, expert opinion.