ABSTRACT
Ramp lesions play a significant role in both anteroposterior and rotational knee stability. Ramp lesions are difficult to diagnose clinically as well as on magnetic resonance imaging. Arthroscopic identification by visualizing the posterior compartment and probing via the posteromedial portal will confirm the diagnosis of ramp lesion. Failure to address this lesion properly will lead to poor knee kinematics, residual knee laxity, and increased chances of failure of reconstructed anterior cruciate ligament. Here, we describe a simple arthroscopic surgical technique to repair ramp lesion, the pass, park, and tie at the end, via 2 posteromedial portals using a knee scorpion suture passing device.
ABSTRACT
Arthroscopic posterior cruciate ligament (PCL) reconstruction is a technically demanding procedure and is associated with several intraoperative and postoperative complications, although less-common but intraoperative iatrogenic popliteal artery injuries have been reported. At our center, we developed a simple and effective technique using a Foley balloon catheter that ensures a safe surgery to avoid possible neurovascular complications. Through a lower posteromedial portal, this inflated balloon acts as protective mechanism between the PCL and posterior capsule. Betadine or methylene blue dye is used to inflate this bulb, which provides easy identification if balloon ruptures, as evidenced by leakage of this solution in posterior compartment. This balloon increases significant distance, equivalent to the diameter of the balloon, between the PCL and popliteal artery by pushing the capsule more posteriorly. This balloon catheter protection technique combined with other methods will ensure a greater level of safety when performing an anatomical PCL reconstruction.
