Operative approaches: Knee

Medial parapatellar approach

In an appropriately marked and consented anaesthetised individual. I would complete the WHO checklist.
  • The patient would be positioned supine, with a sandbag to internally rotate the operative leg.
  • Torniquette to 310mmHg
  • Incision – Medline longitudinal incision 5cm above the superior pole of the patella to the level of the tibial tuberosity
  • Superficial dissection – Subcut tissue, develop flaps, dissect between vastas medialis and quadriceps tendon. 
  • Deep dissection – Incise the medial parapatella retinaculum. reflect the patella laterally.

Patient supine on the table

Anterolateral port – lateral soft spot adjacent to the patella. 5mm stab incision and insert the arthroscopic shaft. Continuous positive pressure pump irrigation to prevent bleeding 50-60mmHg
Anteromedial port. ID medial soft spot adjacent to the patella 5mm stab incision
  • Start in the suprapatella pouch.
  • Patellofemoral joint.
  • Trochlear groove
  • Lateral gutter
  • Lateral compartment
  • Medial gutter
  • Flex knee and look at medial compartment.