Posterior Surgical Approaches

Open posterior surgical approaches to the knee are uncommonly utilized, as advances in arthroscopic techniques allow most posterior pathology to be addressed through anterior arthroscopic portals. Additionally, open posterior approaches can be intimidating given the inherent risks involved to the neurovascular structures of the popliteal fossa. For these reasons, many orthopedic surgeons are not routinely exposed to posterior approaches to the knee during training and may not feel comfortable with open exposure through the popliteal fossa. Despite these factors, open approaches can be useful tools for many sports medicine procedures, most notably Baker’s cyst excision, posterior cruciate ligament inlay reconstruction and repair, and medial meniscus posterior horn repair. A thorough understanding of the anatomy of this region and steps of the exposure can help to facilitate these procedures and avoid any associated complications.