AANA Middle East Arthroscopy Master Course (International)-Knee Arthroscopy

Knee Arthroscopy

Pdf Summary

This document outlines the comprehensive approach to performing knee arthroscopy, presented by Dr. Pietro M Tonino, Chief of Sports Medicine at Loyola University Chicago. It emphasizes the importance of understanding knee anatomy and securing informed consent before surgery, including marking the correct knee, discussing procedure details, expected recovery activities (driving, stairs, work/school, sports), potential complications, and surgery duration.<br /><br />Preoperative protocols include a "time-out" to confirm patient identity and the targeted leg, administration of antibiotics, anesthetic examination, preparation of the surgical area with hair removal and sterile cleaning, and ensuring all instruments are ready. Reviewing clinical notes, MRI reports, and X-rays is critical to confirming the diagnosis and surgical plan.<br /><br />During arthroscopy, the anterolateral portal is the first skin incision near the patellar tendon, followed by the anteromedial portal, with spinal needle guidance as needed. The procedure systematically explores four knee compartments: patellofemoral (patella, trochlea, plica, gutters), medial (meniscus and related structures), intercondylar notch (ACL, PCL), and lateral (meniscus and associated anatomy). Portal selection and scope/instrument positioning vary depending on the meniscus area accessed.<br /><br />Surgeons should accurately describe articular surfaces and lesions, referencing grading systems such as Outerbridge for chondromalacia. Additional posteromedial and posterolateral portals may be employed as necessary.<br /><br />Postoperative care involves communicating findings and prognosis to the patient and their family and follow-up contact the next day. The author stresses the 5 P's: Proper Preparation Prevents Poor Performance. Key points include ensuring informed consent with knee marking, verifying patient and knee identity in the operating room, reviewing clinical documentation and imaging, maintaining a consistent routine to avoid missing pathology, and thorough documentation of findings and procedures performed.

Keywords

knee arthroscopy

Dr. Pietro M Tonino

sports medicine

informed consent

preoperative protocols

anterolateral portal

knee compartments

Outerbridge grading

postoperative care

surgical documentation