OrthoNet

Knee - medial parapatellar approach

* position - supine & tourniquet

* incision - vertical, midline, centered over patella to just med. to tibial tubercle

* no internervous plane

* dissection
- incise subcut. tissue to expose parapatellar retinaculum
- raise small medial flap of skin & subcut. tissue
- incise joint capsule extending from quads tendon to med. parapatellar retinaculum to med. to tibial tubercle
- if not doing TKA, beware of ant. horn of med. meniscus at joint line
- dislocate patella lat. & evert
- flex knee to 90 deg.
- joint fully exposed

* dangers
- infrapatellar branch of saphenous n. - usu cut during this exposure; risk of neuroma
- patellar tendon - problem if it avulses from tibia