AANA Lab Course 913 - Advanced Knee Course-Correcting the Valgus Knee_ What You Need to Know to Get It Done Successfully Reconstructions Faculty Lecture

Correcting the Valgus Knee_ What You Need to Know to Get It Done Successfully Reconstructions Faculty Lecture_ Scott C. Faucett, MD

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Pdf Summary

This presentation by Dr. Scott C. Faucett focuses on safely and effectively accessing different compartments of the knee during arthroscopic surgery without damaging critical structures. Key themes include thorough portal planning, techniques to enhance visualization, and minimizing injury to cartilage, ligaments, and capsules.<br /><br />General portal considerations cover the medial, lateral, posterior, and patellofemoral compartments, emphasizing careful preoperative planning and use of spinal needles to confirm access trajectory. Higher portals, combined with 30-degree scopes, improve visualization and may require creating more than two portals for complex surgeries.<br /><br />A critical technique highlighted is the percutaneous release of the medial collateral ligament (MCL) using an 18-gauge needle on the femoral side, roughly 1 cm proximal to the joint line, which allows safer access to the medial compartment without compromising stability. Postoperative valgus stress radiographs show no adverse outcomes or instability following this method, and early clinical outcomes even favored its use, enabling no brace requirements after meniscectomy.<br /><br />The use of inside-out methods facilitates custom cannula positioning through lateral and trans-tendon portals. The “Gilchrist View” with a 70-degree scope enables comprehensive compartment visualization and serves as a reliable screening technique. Triangulation techniques using needles and switching sticks assist in precise portal placement, and arthroscopic leg holders allow better varus loading without hip rotation, optimizing lateral compartment access.<br /><br />Important landmarks and patient positioning are stressed—knee flexed to 90 degrees, portals placed distal to iliotibial band, and proximal to biceps and popliteus tendons—to improve patellar tracking views and perform procedures like arthroscopic trochleoplasty or loose body removal.<br /><br />Overall, the presentation underscores meticulous portal setup, minimally invasive techniques like percutaneous MCL release, and use of advanced scopes to achieve accurate, safe, and effective knee arthroscopy.

Keywords

knee arthroscopy

portal planning

medial collateral ligament release

arthroscopic visualization

percutaneous MCL release

Gilchrist View

inside-out technique

triangulation methods

arthroscopic leg holders

patellofemoral compartment