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Surgical and Radiologic Anatomy

, Volume 41, Issue 12, pp 1455–1459 | Cite as

Y sign: new landmark for anteromedial portal placement in knee arthroscopy

  • Gordan Gulan
  • Antun ŠumanovacEmail author
  • Hari Jurdana
  • Leo Gulan
Anatomic Bases of Medical, Radiological and Surgical Techniques

Abstract

Purpose

During arthroscopy training process, determination of anteromedial portal is more difficult in contrast with anterolateral portal and frequently results in suboptimal position, and longer operating times. The aim of our study was to identify an anatomical landmark which could facilitate anteromedial portal placement.

Methods

The relationship of the cutaneous veins at the anteromedial side of the knee was analysed regarding the optimally placed anteromedial portal and anatomical landmarks of the anteromedial part of the knee in 70 patients undergoing knee arthroscopy. The study was designed as case series.

Results

In 70% of the patients, the joining of the cutaneous veins was seen after transillumination resembling Y letter. In the remaining 30% of patients, a solitary vein with a curve which corresponds to the joining point was observed. The curve and the joining was located adjacent to optimally placed anteromedial portal measured 2 cm ± 0.3 from the medial patellar tendon border, and 1.1 cm ± 0.1 from the palpable edge of the medial tibial plateau.

Conclusions

The “Y sign” can assist knee arthroscopy trainees in anteromedial portal placement, with the resulting avoidance of multiple puncturing of the skin with the needle, shorter operating room times to find the optimal portal placement, and potential reduction of damage to intraarticular structures.

Keywords

Arthroscopy Knee Anteromedial portal Landmarks 

Notes

Author contributions

GG—project development, data collection, manuscript editing. AŠ—project development, data collection and management, data analysis, manuscript writing and editing. HJ—project development, manuscript editing, data analysis. LG—manuscript writing, data analysis, data collection.

Funding

None.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Clinic for Orthopaedic Surgery Lovran, Medical FacultyUniversity of RijekaLovranCroatia
  2. 2.Department of Anatomy and Neuroscience, Faculty of MedicineJosip Juraj Strossmayer University of OsijekOsijekCroatia
  3. 3.Department of Orthopaedics and TraumatologyCounty General Hospital VinkovciVinkovciCroatia
  4. 4.University Hospital Rijeka, Medical FacultyUniversity of RijekaRijekaCroatia

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