By Hans-Rudolf Henche Dr. med. (auth.)
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Expanding good fortune of arthroplasty of joints just like the hip and knee in addition to issues concerning the long term results of ankle arthrodesis has renewed curiosity in ankle arthroplasty. the recent implants were designed with consciousness to reproducing basic ankle anatomy, joint kinematics, ligament balance, and mechanical alignment.
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Here too, it is advisable to use the inside border of the medial femoral condyle as a landmark and starting point for examination of the knee joint. The tip of the arthroscope is passed along the border of the medial femoral condyle in the direction of the medial joint space. Meanwhile, the knee joint is kept flexed at approximately 90°. In this manner it is possible to inspect almost the whole surface of the articular cartilage which covers the medial condyle. At this stage it is advisable to turn the arthroscope so that the whole of the condyle is included in the field of view of the angled optical system.
29). When the anterior two-thirds of the medial meniscus have been inspected it is best to re37 Fig. 24. Medial femoral condyle with the optical system in the correct rotation position Fig. 25. Medial femoral condyle with the optical system in the incorrect rotation position Fig. 26. Normal medial meniscus with the knee joint flexed at 90° and the lower leg m the neutral rotation position 38 Fig. 27. Attachment of the anterior horn of the medial meniscus, showing the convergmg fibres of the transverse ligament (normal appearance) Fig.
As in the case of the medial meniscus, small longitudinal tears and the less common bucket handle tear are easily identified during arthroscopy (Figs. 54-56). The discoid lateral meniscus is clearly identifiable through the arthroscope. The inexperienced arthroscopist tends to make the diagnosis more frequently since, in many cases, there is hardly any difference in colour between the lateral meniscus and the articular surface of the tibia. The diagnosis is not cer- tain unless one is unable to identify the sharp sickle-shaped posterior horn despite having a clear view of the lateral joint space (Figs.