By Hans-Rudolf Henche Dr. med. (auth.)
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Extra info for Arthroscopy of the Knee Joint
The manoeuvre can be carried out in the reverse direction by extending the knee joint and the instrument then slips back into the femoropatellar joint. On moving the instrument back to its position parallel to the condylar axis its outer tube pushes the infrapatellar fat pad forwards. The insertion of the outer tube of the instrument into the knee joint space cannot be practised often enough. Furthermore, the investigator should check the position of the tip of the instrument repeatedly until he is absolutely sure that it lies within the joint space.
The arthroscope is now carefully withdrawn from the lateral joint space so as to bring the a nterior horn of the lateral meniscus back into the field of view. Along the joint space the lateral recess of the knee joint is then sought. There is a gap of 1- 2 em between the capsule and ligaments of the knee joints and the lateral side of the femoral condyle. The instrument is then slowl y moved in a proxima l direction. The reflection of the capsule and ligaments from the side of the femu r is clearly recog nizable (Figs.
50-53). Pathological Changes in the Lateral Meniscus. The lateral meniscus is visualized in the manner described above. As in the case of the medial meniscus, small longitudinal tears and the less common bucket handle tear are easily identified during arthroscopy (Figs. 54-56). The discoid lateral meniscus is clearly identifiable through the arthroscope. The inexperienced arthroscopist tends to make the diagnosis more frequently since, in many cases, there is hardly any difference in colour between the lateral meniscus and the articular surface of the tibia.