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The Journal of Bone and Joint Surgery 81:138-141 (1999)
© 1999 The Journal of Bone and Joint Surgery, Inc.

Instructional Course Lecture

Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Specialized Exposure for Revision Total Knee Arthroplasty: Quadriceps Snip and Patellar Turndown*{dagger}

ROBERT L. BARRACK, M.D.{dagger}, NEW ORLEANS, LOUISIANA

An Instructional Course Lecture, American Academy of Orthopaedic Surgeons


   Introduction
 
Adequate exposure of the knee is the first step in the successful performance of a revision total knee arthroplasty. In order to safely and expeditiously remove the implants that are in place and insert trial and actual components, flexion well beyond 90 degrees (to about 110 degrees) is needed13. In addition, it is preferable to be able to evert the patella and dislocate the tibia anteriorly. If a patient has less than 80 to 90 degrees of passive flexion under anesthesia, the standard medial parapatellar approach may not provide adequate exposure. Initially, it is useful to start the midline incision more proximally than the previous incision in order to establish normal tissue planes proximal to the extensor mechanism. It is also useful to take additional time to define the borders of the rectus femoris tendon and the vastus lateralis and medialis insertions into the patella. The medial parapatellar capsular . . . [Full Text of this Article]


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