Intra-articular knee fractures are breaks which extend into the joint surface. Based on the fact that the knee is a weight-bearing joint with sliding and rolling mechanics, these fractures require accurate reduction and stabilisation in order to prevent rapid onset of post-traumatic osteoarthritis. These fractures are investigated with standard x-rays, often a CT-scan is required to delineate the fracture fragments accurately and to allow the surgeon to plan the approach. In order to achieve accurate reduction, visualisation is required. As discussed in the section dealing with advantages of minimally invasive surgery, arthroscopy of the knee lends itself ideally to performing indirect fracture reduction and stabilisation without unnecessary damage to the surrounding soft tissue structures. Special arthroscopic precautions are required if an intra-articular fracture is present. Another advantage of arthroscopic examination of an intra-articular fracture of the knee is the fact that meniscal incarceration is often present and may be addressed concurrently. This condition may sometimes be missed if indirect fracture reduction is attempted without direct visualisation i.e. with mobile radiology fluoroscopy only.
