Anterior Drawer Maneuver to Access Knee Posteromedial Compartment.

Abstract

Over the years, diagnostic arthroscopy has been the key to accurately diagnosing lesions in the knee. However, accessing the posterior compartment of the knee remains a challenge for upcoming arthroscopy surgeons. Gillquist was the first surgeon to publish a technique for accessing the posteromedial compartment in 1979, following which several techniques were developed, like modified Gillquist and switching stick maneuvers. According to Gillquist, "posterior compartments are the litterbox of the knee" and the advantages of posterior evaluation include evaluation of ramp lesions, remnants after partial meniscectomy, loose bodies, and to safely create posterior portals for arthroscopic visualization, posterior cruciate ligament (PCL) surgery and ramp repair. However, there is a risk of damaging the lateral portion of the medial femoral condyle chondral damage and broken arthroscope while attempting these blind maneuvers, and these techniques require expertise and more operative time. Our approach aims to simplify these procedures, reducing the time require to access the posteromedial compartment while minimizing the risk of unintended damage to the medial femoral condyle cartilage.