7 - Gaining Surgical Exposure in Total Knee Arthroplasty

Abstract

The importance of safely achieving adequate surgical exposure is tantamount to avoiding complications in revision total knee arthroplasty. Adequate, yet safe visualization of the knee is critical for preservation of bone stock, safe implant removal, and protection of the extensor mechanism. Many challenging complications can be avoided with thorough preoperative patient evaluation and preoperative planning. In the majority of revision total knee arthroplasty cases, a standard medial parapatellar arthrotomy with adjunct exposure techniques can lead to a successful outcome. When a more extensile exposure is needed, surgeons have a number of techniques in their armamentarium, including the quadriceps snip, V-Y turndown, femoral peel, or medial epicondylar osteotomy proximally and the tibial tubercle osteotomy or “banana peel” distally.