Knee Lateral Gutter Anatomy

In the normal knee joint the lateral gutter is closed posteriorly by the popliteus tendon and the arthroscope cannot be placed deeply into the posterolateral compartment through the lateral gutter.

Knee lateral gutter anatomy.

The lateral gutter drive through sign signified as the ability to advance the arthroscope into the posterolateral compartment between a lax popliteus tendon and the lateral femoral condyle suggests an avulsion of the popliteus off the femur. There are bursa located underneath the tendons and ligaments on both the lateral and medial sides of the knee. In those patients with acute proximal avulsion of the popliteus tendon of the femur the bare femoral insertion area with ecchymosis scar tissue. These fluid filled sacs cushion the joint and reduce friction between muscles bones tendons and ligaments.

In its normal state it is tissue paper thin but can become thickened scarred and contracted as a consequence of injury and causes ankylosis and painful tethering of the quadriceps tendon. The tibiofemoral joint which is the main hinge joint of the knee occurs where the femur meets the tibia and includes an inner medial compartment and an outer lateral compartment. There are up to 13 bursa of various sizes in and around the knee. The popliteal hiatus should be identified in this area fig.

With knee flexed to 90 move to medial compartment. It is the weight bearing component of the knee joint. Tibiofemoral medial and lateral condyles of the femur articulate with the tibial condyles. 54 7 and a gentle milking maneuver should be performed to assess for the presence of loose bodies that may move back and forth within the popliteal hiatus.

The patellofemoral joint occurs where the patella and the femur meet behind the kneecap and comprises the third compartment of the knee. The knee joint capsule is the structure surrounding the knee made up of ligaments bone and fluid filled cavities. Anterior horn of lateral meniscus. Gutter and across the suprapatellar pouch flaring out in the lateral gutter to a remnant or to no structure at all.

Lateral gutter the lateral gutter should be visualized and again a similar inspection to the medial gutter should be performed looking for synovitis loose bodies and marginal osteophytes. The joint surfaces are lined with hyaline cartilage and are enclosed within a single joint cavity.