Retraction of infrapatellar fat pad during arthroscopy of the knee

One of the most important requirements for a good arthroscopic procedure is a clear view of the operating field. Infrapatellar fat pad is known to obstruct the field of view inside the knee for an arthroscopic surgeon. A clear view also shortens the operating time and saves valuable time under tourniquet. Different methods have been used to either avoid the fat pad, shave the fat pad, or retract to give a clear view inside the knee joint. We describe a technique using sutures which is simple, safe, inexpensive, reproducible, and effective in providing retraction of the fat pad.

Hip Arthroscopy in a Baseball Catcher without the Use of a Perineal Post: A Crossover Case Report

A 17-year-old Caucasian male high school baseball catcher presented with bilateral hip and groin pain of insidious onset over a 4-year period. Following appropriate physical exam and radiographic testing, bilateral labral tears secondary to cam type femoroacetabular impingement was diagnosed. Arthroscopic corrective surgeries were performed 4 months apart by a single specialized sports medicine orthopedic surgeon. One hip arthroscopic procedure utilized a well-padded perineal traction post and was associated with neuropraxic complications during recovery. The second hip arthroscopic procedure was performed with the table in 15° of Trendelenburg for traction without a perineal traction post and no neuropraxia was noted during recovery. The patient reported that outcomes and postoperative radiographic studies were similar bilaterally; however, perineal nerve neuralgias with the second hip arthroscopy were not reported. While other studies have described the use of post-less traction for mitigation of perineal nerve compression during hip arthroscopic procedures, this crossover observational report is the first to the authors’ knowledge demonstrating both neuropraxia and lack of neuropraxia in a single patient undergoing the same procedure bilaterally where the only difference is the usage of perineal traction posts.