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.