Percutaneous medial collateral ligament release is very often useful during arthroscopic medial meniscus surgery

BACKGROUND: Arthroscopic medial meniscectomy is one of the most widely performed orthopedic procedures. However, sometimes, the posterior horn of the medial meniscus is poorly visualized. The purpose was to identify how many patients with medial meniscus tears undergoing arthroscopic meniscectomy require a partial release of the medial collateral ligament (MCL), at what degree of opening of the medial compartment is the procedure necessary and the amount of space obtained after the release.METHODS: Sixty-four patients with medial meniscus tears were prospectively included. Patients were excluded if they had associated ligamentous tears of the affected knee, prior surgical interventions and meniscus tears amendable to repair. During surgery, the opening in the medial compartment was measured with a probe with a 4 mm tip. The following characteristics were documented: the opening of the medial compartment as the distance between the medial femoral condyle and the tibial plateau, the opening obtained after the procedure if the release was necessary and how many patients required the release procedure.RESULTS: Thirty-nine patients, representing 60.9% (95%CI [48.5-73.4]), had an MCL release procedure in order to increase visualization and access to the tear. Every case that required a release had a medial side opening of less than 5 mm, with a mean value of 3.6±0.52 mm. After the release the mean distance between the femoral condyle and the tibial plateau was 8.1±1.04 mm (P<0.001).CONCLUSIONS: We found this technique to be very effective and very often necessary during routine arthroscopic medial meniscectomy in patients without associated ligamentous instability in order to improve visualization and access to the tear site.