anteromedial

Timing of Surgery

Issue

- reported higher incidence with immediate reconstruction in acute phase

- reduced by settling inflammation / effusion and obtaining FROM

- always best to delay if not professional athlete

- problematic if patient has locked bucket handle mensical tear

Results

Bottoni et al Am J Sports Med 2008

- RCT of early (average 9 days) v late reconstruction (average 85 days)

Portals

1.  Anterolateral

Viewing portal

- 1cm lateral to patella tendon

- 1cm above joint line

- 1 cm below inferior pole patella

Problems

- too medial, in fat pad

- too high, limitation by patella, difficult to see posterior horns

- too low, damage anterior horn meniscus

Limitations

- PCL

- anterior horn LM