Knee Arthroscopy: Technique and Normal Anatomy

  • Anthony Schena
  • Glen Ross

Arthroscopy of the knee is the most common orthopaedic procedure performed in the United States [1–6]. Given the frequency of this procedure, it is hard to fathom that knee arthroscopy did not enter into the mainstream of orthopaedic surgery until the 1970s. In 1969, Masaki Wantanabe and colleagues published the Atlas of Arthroscopy [7]. In their seminal publication, they described the results of their first arthroscopic procedure, the removal of an intraarticular pigmented villonodular synovitis (PVNS), and provided pictures of their first arthroscopic meniscectomy. Jackson and Abe followed up on the work of their Japanese peers with the publication of their arthroscopic technique and outcomes in 1972 [8]. Arthroscopy of the knee became an accepted practice in the 1970s.


Anterior Cruciate Ligament Anterior Cruciate Ligament Reconstruction Deep Venous Thrombosis Posterior Cruciate Ligament Lateral Meniscus 


  1. 1.
    Garrett WE, Swiontkowski MF, Weinstein JN, Callaghan J, Rosier RN, Berry DJ, Harrast J, Derosa GP. American Board of Orthopaedic Surgery Practice of the Orthopaedic Surgeon: Part II, Certification Examination Case Mix. J Bone Joint Surg Am 2006;88:660–667.PubMedCrossRefGoogle Scholar
  2. 2.
    Kim TK, Savino RM, McFarland EG, Cosgarea AJ. Neurovascular complications of the knee. Am J Sports Med 2002;30:619–629.PubMedGoogle Scholar
  3. 3.
    McGinty JB, Johnson LL, Jackson RW, McBryde AM, Goodfellow JW. Uses and abuses of arthroscopy: a symposium. J Bone Joint Surg Am 1992;74:1563–1577.PubMedGoogle Scholar
  4. 4.
    Rodeo SA, Forester RA, Weiland AS. Neurologic complications due to arthroscopy. [Current Concepts Review]. J Bone Joint Surg Am 1993;75:917–926.PubMedGoogle Scholar
  5. 5.
    Small NC. Complications in arthroscopic surgery of the knee and shoulder. Orthopedics 1993;16:985–988.PubMedGoogle Scholar
  6. 6.
    Small NC. Complications in arthroscopic surgery performed by experienced arthroscopists. Arthroscopy 1988;4:215–221.PubMedCrossRefGoogle Scholar
  7. 7.
    Wantanabe M, Takeda S, Ikeuchi H. Atlas of Arthroscopy. 2nd ed. Tokyo: Igaku Shoin Ltd., 1969.Google Scholar
  8. 8.
    Jackson RW, Abe I. The role of arthroscopy in the management of disorders of the knee. J Bone Joint Surg Br 1972;57:310.Google Scholar
  9. 9.
    Johnson LL. Diagnostic and Surgical Arthroscopy: The Knee and Other Joints. St. Louis, MO: CV Mosby, 1981.Google Scholar
  10. 10.
    Metcalf RW. An arthroscopic procedure for lateral release of the subluxing or dislocating patella. Clin Orthop 1982;667:9.Google Scholar
  11. 11.
    McGinty JB (ed.). Operative Arthroscopy. New York: Raven Press, 1996.Google Scholar
  12. 12.
    McGinty JB, Freedman PA. Arthroscopy of the knee. Clin Orthop 1976;121:173.PubMedGoogle Scholar
  13. 13.
    Gries P, Bandana D, Holstrom M, Burks RT. Meniscal injury: I. Basic science and evaluation. J Am Acad Orthop Surg 2002;10:168–176.Google Scholar
  14. 14.
    Vedi V, Spouse E, Williams A, Tennant JJ, Hunt D, Gedroyc W. Meniscal movement: an in-vivo study using dynamic MRI. J Bone Joint Surg Br 1999;81:37–41.PubMedCrossRefGoogle Scholar
  15. 15.
    Cupte CM, Bull AM, Thomas RD, Amis AA. A review of the function and biomechanics of the meniscofemoral ligaments. Arthroscopy 2003;19:161–171.Google Scholar
  16. 16.
    Kusayama T, Harner CD, Carlin GJ, Xerogeanes JW, Smith BA. Anatomical and biomechanical characteristics of human meniscofemoral ligaments. Knee Surg Sports Traumatol Arthrosc 1994;2:234–237.PubMedCrossRefGoogle Scholar
  17. 17.
    Wan AC, Felle P. The meniscofemoral ligaments. Clin Anat 1995;8:323–326.PubMedCrossRefGoogle Scholar
  18. 18.
    Fitzgibbons RE, Shelbourne KD. Aggressive non-treatment of lateral meniscal tears seen during anterior cruciate ligament reconstruction. Am J Sports Med 1995;23:156–159.PubMedCrossRefGoogle Scholar
  19. 19.
    Ekman EF, Wahba M, Ancona F. Analgesic efficacy of perioperative celecoxib in ambulatory knee surgery. Arthroscopy 2006;22:635–642.PubMedCrossRefGoogle Scholar
  20. 20.
    Denti M, Randelli P, Bigoni M, Vitale G, Marino R, Fraschini N. Pre- and postoperative intra-articular analgesia for arthroscopic surgery of the knee and arthroscopic assisted anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 1997;5:206–212.PubMedCrossRefGoogle Scholar
  21. 21.
    Miskulin M, Maldini B. Outpatient arthroscopic knee surgery under multimodal analgesic regiments. Arthroscopy 2006;22: 978–983.PubMedCrossRefGoogle Scholar
  22. 22.
    Munk S, Pederson K. Knee arthroscopy under local anesthesia with or without anesthesiologic assistance. Ugeskr Laeger 1994;156:313–316.PubMedGoogle Scholar
  23. 23.
    Shapiro MS, Safran MR, Crockett H, Finerman GAM. Local anesthesia for knee arthroscopy: efficacy and cost benefits. Am J Sports Med 1996;23:50–53.CrossRefGoogle Scholar
  24. 24.
    Jacobson E, Forssblad M, Rosenberg J, Westman L, Weidenhielm L. Can local anesthesia be recommended for routine use in elective knee arthroscopy? A comparison between local, spinal and general anesthesia. Arthroscopy 2000;16:183–190.PubMedCrossRefGoogle Scholar
  25. 25.
    Fulkerson JP. Anteromedial tibial tubercle transfer. In Jackson DW (ed.), Reconstructive Knee Surgery. 3rd ed. Philadelphia: Lippincott Williams & Wilkins, 2008.Google Scholar
  26. 26.
    Deutch A, Wyzykowski RJ, Victoroff BN. Evaluation of the anatomy of the common peroneal nerve. Defining nerve at risk in arthroscopically assisted lateral meniscus repair. Am J Sports Med 1999;27:10–15.Google Scholar
  27. 27.
    Irrang JJ, Harner CD. Loss of motion following knee ligament reconstruction. Sports Med 1995;19:150.CrossRefGoogle Scholar
  28. 28.
    Milankov M, Savic D, Miljkovic N. Broken blade in the knee: a complication of arthroscopic menisectomy. Arthroscopy 2002;18:E4.PubMedGoogle Scholar
  29. 29.
    Oldenburg M, Mueller RT. Intra-articular foreign body after arthroscopy. Arthroscopy 2003;19:1012–1014.PubMedCrossRefGoogle Scholar
  30. 30.
    In Y, Bank WJ, Park JB. Detachment of the tip of a motorized shaver within the knee joint: a complication of arthroscopic surgery. Arthroscopy 2003;19:257.CrossRefGoogle Scholar
  31. 31.
    Kaper BP, Carr CF, Shirreffs TG. Surgery of the knee: a report of two cases of compartment syndrome managed non-operatively. Am J Sports Med 1997;25:123–125.PubMedCrossRefGoogle Scholar
  32. 32.
    Reigstad O, Grinsgaard C. Complications in knee arthroscopy. Knee Surg Sports Traumatol Arthrosc 2006;14:473–477.PubMedCrossRefGoogle Scholar
  33. 33.
    Ilahi O, Reddy J, Ahmad I. Deep venous thrombosis after knee arthroscopy. Arthroscopy 2005;21:727–730.PubMedCrossRefGoogle Scholar
  34. 34.
    Delis KT, Hunt N, Strachan RK, Nicolaides AM. Incidence, natural history and risk factors of deep venous thrombosis in elective knee arthroscopy. Throm Haemost 2001;86:817–821.Google Scholar
  35. 35.
    Hoppener M, Rettema HB, Henry CP, Verhegen C, Büller HR. Low incidence of deep venous thrombosis after knee arthroscopy without thromboprophylaxis. Acta Orthop 2006;77: 767–771.PubMedCrossRefGoogle Scholar
  36. 36.
    Michot M, Conen D, Holt D, Erni D, Zumstein M, Ruflin G, Renner N. Prevention of deep venous thrombosis in ambulatory arthroscopic knee surgery. Arthroscopy 2002;18: 257–263.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Anthony Schena
    • 1
  • Glen Ross
    • 2
  1. 1.Department of OrthopaedicsNew England Baptist HospitalBostonMassachusetts
  2. 2.Department of Orthopaedics, New England Baptist HospitalAssistant Professor of Surgery, Tufts School of MedicineBoston

Personalised recommendations