A Novel MCL Sparing Arthroscopic-Assisted Approach to Posteromedial Plateau

Objective: With Currently available approaches from medial aspect to the knee it is not possible to access the anteromedial and posteromedial knee plateau simultaneously. Disadvantages to the current techniques, among others, are possible failure of medial capsular repair, development of lateral patellar instability (medial parapatellar), being less extensile, struggling in obese patients, difficulties with flexion contractures, potential for partial VMO denervation (midvastus), etc. Methods: Herein, we are reporting on an innovative technique we have developed for arthroscopic assisted extensile approach to the tibial plateau from medial side that helps open reduction and internal fixation of multifragmentary fractures. Results: In contrast to the currently available approaches from medial aspect to the knee the novel approach makes it possible to access the anteromedial and posteromedial knee plateau simultaneously, helps avoiding multiple incisions, arthroscopic-assisted reattachment of medial collateral ligament to the meniscus, preserve the coronary attachment of medial meniscus to the tibial plateau, and proximal and distal attachments of the medial collateral ligament. Conclusions: Studies with long follow-up and large sample size will be required to examine the clinical outcome of novel techniques.