chapter 5: Arthroscopy of the patellofemoral joint

Arthroscopy of the Patellofemoral Joint

David A. Buuck and John P. Fulkerson

"Eventually all things merge into one And the river runs through it."

Arthroscopy is an extremely important adjunct in the diagnosis and treatment ofpatellofemoral joint disorders Many authors have reported their results (1‑7).

The key to success in each patient depends on a good preoperative history/physical examination as well as accurate interpretation of imaging data before the operation itself. Many complications have arisen from inappropriate arthroscopic procedures on patients that had had an inadequate preoperative examination. Accurate diagnosis will help avoid the dreaded multiply operated knee. It seems each additional surgery becomes more involved and attempts to overcome the initial inappropriate procedure. This builds to a crescendo in an unhappy patient with a painful knee that makes the orthopedist ask himself, "What went wrong?" This chapter deals with the indications, techniques, and results of patellofemoral arthroscopy, with the hope that well‑done arthroscopy will help establish accurate decision making and thereby avoid complications.

Patellofemoral arthroscopy must be regarded as only one part of a thorough examination of the knee joint and not as an isolated procedure. Surgical applications in this chapter include:

  1. Diagnostic viewing of all anterior knee articular structures and observation of patellar tracking and trochlear dysplasia.
  2. Description of size, depth, and location of articular lesions.
  3. Debridement of the patella and trochlea.
  4. Arthroscopic lateral release.
  5. Arthroscopic proximal realignment  
  6. Arthrocopic arthroplasy
  7. Resection of symptomatic plica and synovium.

 

        

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