Knee – Lateral Approach

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.