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Surgical Approaches to the Posteromedial and Posterolateral Aspects of the Knee

Dr. Medvecky is Assistant Professor, Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT. Dr. Noyes is President and Medical Director, Cincinnati Sportsmedicine Research and Education Foundation, Deaconess Hospital, Cincinnati, OH.

Reprint requests: Dr. Medvecky, Yale University School of Medicine, PO Box 208071, New Haven, CT 05620-8071.

Surgical approaches to the posterior aspect of the knee are not commonly needed, and their use has become even rarer with the increasing sophistication of arthroscopic technology. As a result, physicians in orthopaedic surgical training are not often exposed to the practical use of surgical dissection around the posterior corners of the knee. For certain procedures, however, greater clinical utility and decreased surgical morbidity render focused posterior exposure the preferred alternative to the classic popliteal dissection with its wide exposure of the popliteal anatomy. Surgical indications include ligament repair or reconstruction around the posteromedial or posterolateral aspect of the knee, inside-out meniscal repair, posterior cruciate ligament tibial inlay reconstruction, and Baker’s cyst excision. To minimize complications, these focused approaches require adeptness with the complex anatomy of the posterior, posteromedial, and posterolateral aspects.

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