The value of intercondylar notch visualization of the posteromedial and posterolateral compartments during knee arthroscopy

The intercondylar notch views allow for visualization of the posteromedial and posterolateral compartments of the knee without the use of accessory portals. The purpose of this study was to prospectively evaluate whether these views are useful either diagnostically or therapeutically in the performance of knee arthroscopy. Two surgeons at one institution performed 150 consecutive knee arthroscopies. After arthroscopic examination of the knee using standard portals, a diagnosis and treatment decisions were made. Thereafter, visualization of the posteromedial and posterolateral compartments through the intercondylar notch was undertaken. Each view was performed initially with a 30° arthroscope and 3 questions were asked: (1) Did the view change the diagnosis or add additional information? (2) Did it change the surgical treatment? (3) Was it useful during performance of the procedure? The 70° arthroscope was then used and the same three questions were addressed. In 20.6% of the cases, the intercondylar notch views made a diagnostic and/or therapeutic difference, and the surgical procedure was changed in 11.3% based solely on this information. The views were 3 times as likely to make a difference in anterior cruciate ligament (ACL) reconstructions when compared with arthroscopy without ACL reconstruction (P < .01). The 70° arthroscope added nominal additional information There were no significant complications. We advocate visualization of the posteromedial and posterolateral compartments through the intercondylar notch as a valuable part of routine knee arthroscopy.