Arthroscopic approach to the posterior compartment of the knee using a posterior transseptal portal

作     者：Tsuyoshi Ohishi Masaaki Takahashi Daisuke Suzuki Yukihiro Matsuyama 

作者机构：Department of Orthopedic SurgeryEnshu Hospital Joint CenterJyuzen Memorial Hospital Department of Orthopedic SurgeryHamamatsu University School of Medicine 

出 版 物：《World Journal of Orthopedics》 (世界骨科杂志（英文版）)

年 卷 期：2015年第6卷第7期

页      面：505-512页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Arthroscopic surgery Knee Posterolateral portal Posteromedial portal Transseptal portal 

摘      要：Arthroscopic surgery of the posterior compartment ofthe knee is difficult when only two anterior portals are used for access because of the inaccessibility of the back of the knee. Since its introduction, the posterior transseptal portal has been widely employed to access lesions in the posterior compartment. However, special care should be taken to avoid neurovascular injuries around the posteromedial, posterolateral, and transseptal portals. Most importantly, popliteal vessel injury should be avoided when creating and using the transseptal portal during surgery. Purpose of the present study is to describe how to avoid the neurovascular injuries during establishing the posterior three portals and to introduce our safer technique to create the transseptal portal. To date, we have performed arthroscopic surgeries via the transseptal portal in the posterior compartments of 161 knees and have not encountered nerve or vascular injury. In our procedure, the posterior septum is perforated with a 1.5-3.0-mm Kirschner wire that is protected by a sheath inserted from the posterolateral portal and monitored from the posteromedial portal to avoid popliteal vessel injury.