EXPOSURE OPTIONS: GETTING THERE SAFELY
2018
Minimal or Less Invasive ApproachesLimited medial parapatellar incision – 2–3 inch medial incision; Best for unicompartmental implant; patellar visualization poor; Less invasive but limited visualization therefore overall joint inspection is compromised.MIS TKR approaches - Mini midvastus approach popularised by S.B. Haas - Ideal BMI 30 or less; Incision length 10cm; Vastus incision about 2–3cm; Vastus incision beyond 5–6cm places motor branch to VMO at risk; Coupled with downsized cutting blocks, allows predictable ability to perform TKR; Sliding window concept; Patella eversion not necessary.Mid Subvastus approach – 10cm skin incision; Sub vastus dissection up to septum (watch for bleeders!); VERY difficult in muscular males!Standard IncisionsStandard medial parapatellar approach - Familiar to most surgeons; Medial arthrotomy facilitates exposure for almost all procedures; Can become more extensile by incising the quad tendon further proximal; Release of posteromedial capsule and semi-membraneosus allow...
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