OrthoNet

Knee - lateral approach

* position - supine with sandbag under buttock & knee flexed to 90 deg.

* incision
- long, curved incision
- at level of mid patella & 3 cm lat. to it
- with knee flexed, cut inf. over Gerdy’s tubercle & 4-5cm distal to joint line
- curve upper end to follow line of femur

* internervous plane - btw biceps femoris (sciatic n.) & IT band

* dissection
- mobilize skin flaps
- incise fascia in interval btw IT band & BF
- avoid CPN on post. border of BF tendon
- retract ITB ant. & BF post.
- uncover superficial LCL running from lat. epicondyle to head of fibula
- enter joint either ant. or post. to superfical LCL

> ant. arthrotomy
- to inspect entire lat. meniscus
- begin arthrotomy 2 cm above joint line

> post. arthrotomy
- find lat. head of gastroc. at its origin at back of lat. condyle
- dissect btw it & posterolat. corner of joint capsule
- watch for lat. sup. genicular art.
- watch for popliteus
- long. incision in capsule starting well above joint line to avoid meniscus

* dangers
- CPN - lies on post. border of BF tendon
- lat. sup. genicular art. - runs btw lat. head of gastroc. & posterolat. capsule
- popliteus tendon - travels within joint before it attaches to post. aspect of meniscus & femur
- lat. meniscus
- coronary lig.