title: Needle assisted arthroscopic clysis of the medial collateral ligament of the knee: a simple technique to improve exposure in arthroscopic knee surgery.
abstract: During knee arthroscopy, narrowness and tightness maybe encountered in the medial compartment that does not allow sufficient visualization or instrumentation. When this occurs, our team has found it helpful to perform a percutaneous clysis of the deep portion of the medial collateral ligament with a spinal needle. With the knee positioned in 10° to 20° of flexion and a valgus stress is applied. A spinal needle (18 Gauge) is passed percutaneously through the medial collateral ligament between the tibial plateau and undersurface of the medial meniscus. Several passes are made with the spinal needle with the bevel of the needle angled to selectively divide the fibers while keeping the medial collateral ligament under tension. Then with controlled valgus force, the medial compartment will progressively open allowing improved visualization to the posteromedial corner of the knee. This increase in space gives an enhanced visual field and further allows more room for arthroscopic instrumentation.
authors.affiliation: Division of Sports Medicine and Shoulder Surgery, Boston University School of Medicine , Boston Medical Center, MA.
authors.forename: Xinning
authors.initials: X
authors.lastname: Li
authors.affiliation: Orthopaedic Surgery and Sports Medicine , New Brunswick, NJ.
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Selby
authors.affiliation: Division of Sports Medicine, Hospital for Special Surgery , New York, NY, USA.
authors.forename: Ashley
authors.initials: A
authors.lastname: Newman
authors.affiliation: Division of Sports Medicine, Hospital for Special Surgery , New York, NY, USA.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: O'Brien
keywords: knee arthroscopy; ligament release; medial collateral ligament; menisectomy