Posterior Surgical Approach to the Knee

Faucett, Scott C.; Gannon, James; Chahla, Jorge; Ferrari, Márcio B.; LaPrade, Robert F.

doi:10.1016/j.eats.2016.10.013

Cited by 12 publications

(15 citation statements)

References 10 publications

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“…The combined posterior approach of synovectomy and tumor excision is adopted when the dominant tumor shows posterior extension [ 1 , 2 ]. Direct posterior (DP) surgical dissection around the popliteal fossa of the knee joint is a traditional surgical approach of the posterior knee [ 22 , 23 ]. As previously mentioned, the main limitation of DP approach is the risk to the neurovascular structures within the knee [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Modified posterior approach of the knee in patients with diffuse pigmented Villonodular synovitis: case series of a single Institution’s experience

Wei

Yang

2022

BMC Musculoskelet Disord

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Background Diffuse pigmented villonodular synovitis (DPVNS) is a challenging tumor-like disorder that mainly occurs in the anterior aspect of the knee joint. The growth may sometimes extend to the posterior knee joint. Surgical excision is the mainstream treatment for DPVNS, and the posterior approach of tumor excision is adopted when the dominant tumor shows posterior extension. However, the optimal surgical approach over the posterior knee remains unknown. Methods Patients with DPVNS of the knee joint who received the posterior approach of synovectomy from 1995 to 2019 were retrospectively reviewed to describe the modified separate posterior (SP) approaches, and evaluate the treatment outcomes in a case series of DPVNS knees. The results of the SP approach was also compared with those of traditional direct posterior (DP) approach. Postoperative functional outcomes were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) standardized questionnaire and clinician-completed Musculoskeletal Tumor Society (MSTS) functional rating system at outpatient department. Results A total of 20 DPVNS knees were included. Thirteen patients who received SP approaches were included in the SP group, while seven patients who received the DP approach were included in the DP group. The median follow-up times were 5.7 years (IQR, 2-8.8) in the SP group and 3 years (IQR, 2-5.3) in the DP group. Both groups showed satisfactory safety. The SP group presented higher postoperative mean WOMAC (91.23 ± 7.20) and mean MSTS (24.23 ± 2.68) than the DP group (mean WOMAC: 76.00 ± 16.57; mean MSTS: 22.43 ± 4.69). The Wilcoxon signed-rank test was use to compare preoperative and postoperative range of motion (ROM) for each group. The significant difference in SP group (p = 0.004) was found while p = 0.131 in DP group. Conclusions The SP approach provides an effective approach with satisfactory outcomes for the surgical treatment of DPVNS knees.

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Section: Introductionmentioning

confidence: 99%

Modified posterior approach of the knee in patients with diffuse pigmented Villonodular synovitis: case series of a single Institution’s experience

Wei

Yang

2022

BMC Musculoskelet Disord

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“… 18 In order to allow for anatomic allograft placement, a technically challenging posterior approach may be required. 7 , 19 , 20…”

Section: Introductionmentioning

confidence: 99%

Posterior Approach for the Treatment of an Osteochondral Defect on the Posterior Lateral Femoral Condyle

Rodriguez

Roethke

Liechti

et al. 2022

Arthroscopy Techniques

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“…The posterior knee holds a high risk for surgical access due to the dense field of neurovascular structures located in and around the popliteal fossa [ 1 ]. Because of the inherent high risk and unfamiliar relevant surgical anatomy, many surgeons avoid this region altogether [ 1 , 2 ]. The main limitation to a direct open posterior approach to the knee is the risk posed to the neurovascular structures [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

“…Because of the inherent high risk and unfamiliar relevant surgical anatomy, many surgeons avoid this region altogether [ 1 , 2 ]. The main limitation to a direct open posterior approach to the knee is the risk posed to the neurovascular structures [ 1 ]. An in-depth knowledge of the surgical anatomy of these neurovascular structures will assist in minimizing the risk of neurovascular damage.…”

Section: Introductionmentioning

confidence: 99%

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Defining the popliteal fossa by bony landmarks and mapping of the courses of the neurovascular structures for application in popliteal fossa surgery

et al. 2021

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Surgical access to the posterior knee poses a high-risk for neurovascular damage. The study aimed to define the popliteal fossa by reliable bony landmarks and comprehensively mapping the neurovascular structures for application in posterior knee surgery. Forty-five (20 male, 25 female) embalmed adult cadaveric knees were included. The position of the small saphenous vein (SSV), medial cutaneous sural nerve (MCSN) and lateral cutaneous sural nerv (LCSN), tibial nerve (TN) and common fibular nerve (CFN) nerves, and popliteal vein (PV) and popliteal artery (PA) were determined in relation to either medial (MFE) or lateral (LFE) femoral epicondyles, medial (MTC) and lateral (LTC) tibial condyles and the midpoint between the MFE and MTC and LFEF and LTC. The distance between the MFE and the PA, PV, TN, MCSN, and SSV was 38.4±12.1 mm, 38.4±12.9 mm, 39.4±10.2 mm, 39.2±14.0 mm and 37.6±12.5 mm respectively for males and 34.6±4.9 mm, 32.8±5.6 mm and 38.0±8.1 mm 38.8±10.1 mm and 37.9±8.2 mm respectively for females. The distance between LFE and the CFN and LCSN was 13.4±8.2 mm and 24.9±7.3 mm respectively for males and 8.4±9.1 mm and 18.4±10.4 mm respectively in females. This study defined the popliteal fossa by reliable bony landmarks and provided a comprehensive map of the neurovascular structures and will help to avoid injuries to the important neurovascular structures.

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Posterior Surgical Approach to the Knee

Cited by 12 publications

References 10 publications

Modified posterior approach of the knee in patients with diffuse pigmented Villonodular synovitis: case series of a single Institution’s experience

Modified posterior approach of the knee in patients with diffuse pigmented Villonodular synovitis: case series of a single Institution’s experience

Posterior Approach for the Treatment of an Osteochondral Defect on the Posterior Lateral Femoral Condyle

Defining the popliteal fossa by bony landmarks and mapping of the courses of the neurovascular structures for application in popliteal fossa surgery

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