Single-Portal Versus Two-Portal Knee Arthroscopy: First Clinical Experience With a New Surgical Technique

摘要

This pilot study compared efficacy, morbidity, and complication rates with a new single-portal arthroscopy technique and traditional 2-portal knee arthroscopy. This prospective study evaluated 156 patients who underwent arthroscopic knee surgery, 106 with 2 portals and a traditional arthroscope and instruments and 50 with a single portal and newly designed arthroscopy instruments. Patients who had reconstructive procedures, microfractures, lateral release procedures, advanced osteoarthritis, and revision surgery were excluded, as were obese patients. The same surgeon performed all procedures, and the patient groups had no significant differences in sex, age, types of pathology, surgical treatment, medications given, or rehabilitation protocol. All patients were examined and completed questionnaires 1 week, 1 month, and 3 months postoperatively. The surgeon was blinded to the data. Follow-up was 100%. The single-portal technique was technically feasible for treatment of knee pathology in 49 of 50 patients. The 2-portal technique provided adequate treatment of knee pathology in all 106 cases. No difference was reported in pain level in the recovery room or on postoperative day 2. However, patients in the single-portal group reported less pain on day 4 (P=.04) and day 7 (P=.004) and were less likely to use oral narcotic analgesics (P=.0001). The single-portal group reported better function in activities of daily living at 1 month and less interference with sports participation at 3 months. Complication rates were no different in the 2 groups. The findings showed that the single-portal technique improved functional recovery at 1 month and 3 months postoperatively and may result in less morbidity in some parameters.