Arthroscopic Release of the Deep Medial Collateral Ligament to Assist in Exposure of the Medial Tibiofemoral Compartment  Pooya Javidan, M.D., Mohammed Ahmed, M.D., Scott G. Kaar, M.D.  Arthroscopy Techniques  Volume 3, Issue 6, Pages e699-e701 (December 2014) DOI: 10.1016/j.eats.2014.09.002 Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 1 Steps of arthroscopic deep MCL release in 1 patient. The medial compartment is visualized by a 30° arthroscope through standard (A) anterolateral and (B) anteromedial portals. With valgus stress placed on the knee near full extension, a 4-mm probe points to the medial femoral condyle. This shows the tight nature of the compartment and inadequate visualization of the posterior structures. (C) A sled is introduced into the medial compartment from the lateral portal, which will protect the tibial chondral surface during blade advancement. (D) A 3.0-mm banana blade is introduced over the meniscal repair sled underneath the medial meniscus to release the deep MCL. (E) The deep MCL is released, starting from the middle third of the medial meniscus, working posteriorly. (F) The release is continued posteriorly only as much as is needed to sufficiently visualize all posterior medial structures. After the release has been performed, the same 4-mm probe is seen from the (G) anteromedial and (H) anterolateral portals, showing improved visualization and identification of a bucket-handle medial meniscal tear that was previously obscured. Arthroscopy Techniques 2014 3, e699-e701DOI: (10.1016/j.eats.2014.09.002) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 2 Banana blade. A slight curve is introduced into the blade to facilitate safe access to the undersurface of the medial meniscus. Arthroscopy Techniques 2014 3, e699-e701DOI: (10.1016/j.eats.2014.09.002) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions