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The Journal of Bone and Joint Surgery (American) 84:S105-S108 (2002)
© 2002 The Journal of Bone and Joint Surgery, Inc.

Scientific Exhibits

Posterior Medial Capsular Release and External Rotation of the Tibia to Enhance Exposure During Total Knee Arthroplasty

Wayne M. Goldstein, MD, Jill J. Branson, RNBSN and Kimberly Berland, SACST


Corresponding author: Jill J. Branson, RN, BSN
Illinois Bone and Joint Institute, 150 North River Road, Suite 100, Des Plaines, IL 60016. E-mail address: jjbibji@aol.com

In support of their research or preparation of this manuscript, one or more of the authors received grants or outside funding from DePuy. None of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. A commercial entity (DePuy) paid or directed, or agreed to pay or direct, benefits to a research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

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   Introduction
 
Enhanced proximal tibial exposure allows precise resection of the proximal surface of the tibia and seating of the tibial component during total knee arthroplasty. The technique described in this article is performed on a fully open knee with a scalpel and does not require the use of an osteotome in a blind fashion. During procedures to correct a varus deformity, improved proximal exposure aids the surgeon during release of the deep medial collateral ligament and any flexion contracture, consequently allowing balance of the ligaments. This paper describes the simple and reproducible surgical technique of proximal tibial exposure.


   Methods
 
This technique was used during 2,500 consecutive primary total knee arthroplasties that involved the use of a posterior cruciate-retaining total knee.

With the leg in extension, the incision progresses 3 cm proximal to the superior pole of the medial portion of the patella and 3 mm lateral to the edge of the quadriceps . . . [Full Text of this Article]


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