APEX Knee Navigating Pearls and Pitfalls-Tips and Tricks for Your Practice

Video Transcription

Video Summary

The speaker thanks the volunteer faculty and shares practical “tricks” from knee sports surgery. For patellofemoral assessment, he tests distal malalignment in clinic by flexing the knee ~30° and externally rotating to see if symptoms change. For all-inside ACL reconstruction, he marks the femoral footprint using a 7‑mm offset guide through the anteromedial portal to orient tunnel placement. In cartilage cases, he describes mincing a loose-body fragment and securing it with fiber/glue as a DeNovo-like patellofemoral solution when coverage is difficult.<br /><br />The talk then focuses on maximizing meniscus visualization: positioning (posts, leg holders, muscle relaxation), using a spinal needle to deflect the meniscus for safer trimming, and “pie-crusting” the superficial MCL with a spinal needle to open a tight medial compartment. Panelists emphasize consistent setup, portal placement, accessory portals, and scope switching.<br /><br />Finally, they discuss MPFL reconstruction pearls (fluoroscopy, correct anchor position, avoid overtensioning) and arthroscopic MPFL imbrication for select cases, plus osteochondral allograft tips (alignment films, sizing, graft handling, avoid proud plugs).

Asset Caption

Moderator: Mark T. Wichman, M.D.
Panel: Zahab S. Ahsan, M.D., Joseph D. Lamplot, M.D., Sanjeev Bhatia, M.D.

Keywords

patellofemoral assessment

all-inside ACL reconstruction

meniscus visualization techniques

pie-crusting superficial MCL

MPFL reconstruction pearls

osteochondral allograft tips