7 The extensile lateral parapatellar arthrotomy and the “ Swashbuckler ” technique have been established to be safe and effective approaches to the knee. DESCRIPTION OF OPERATION: A limited arthrotomy was made, centered around the patella. A standard medial or lateral parapatellar incision and arthrotomy are used for exposure. APPROACH • Knee – Parapatellar • Patient supine • Leg fully extended (flexion of up to 15o is permissible) • Medial point of entry is 2-3 o’clock • Lateral point of entry is 9-10 o’clock • Insert needle perpendicular to knee 27. Lateral unicompartmental replacement: A difficult but rewarding procedure The rarity of the procedure adds to its difficulty, but one physician says the results can be worth it. A lateral parapatellar arthrotomy approach to the joint is most common: The intra-articular structures are examined, torn fibers of the cranial cruciate ligament (CCL) are often debrided (although no evidence exists that debridement improves recovery), and any meniscal damage is addressed. It was perhaps 2 fingerbreadths above and below along the line of her previous incision. Next, the knee joint was thoroughly irrigated with nine liters of normal saline, the middle three liters of which contained 100,000 units of bacitracin. Dissection was carried down to the capsule which was entered through a medial parapatellar type approach. A modified lateral parapatellar arthrotomy is then performed. 8 – 10 However, familiarity with Excessive soft tissue dissection can result in osseous devascularization and If the lesion is on the central portion of the condyle, a mini-arthrotomy can be used. More complex intraarticular fractures (particularly those involving the medial femoral condyle) are better exposed with a lateral parapatellar approach. The medial parapatellar approach is the standard arthrotomy but has been shown in total knee arthroplasty to damage the patellar blood supply and increase postoperative patellar instability. Medial fractures use a medial parapatellar approach. No purulent pus was encountered in the knee joint. Horizontal cut 7-8 mm below the original tibial plateau with protection of the lateral collateral ligament. Marcy. The arthrotomy techniques of knee surgery may cause varying degrees of disruption to the tissue blood supply. Flaps that are raised should be full thickness down to the crural fascia and retinaculum and include the subcutaneous fat (Fig. Exposure of the lateral compartment and removal of osteophytes. There is some concern that this adds complexity in the event that conversion to a TKA is required or that future revision surgery will be more of a challenge. Next, a 6 cm anterior incision was made, and a lateral parapatellar arthrotomy was performed. lateral compartment, a lateral parapatellar incision and arthrotomy are often used. 30-10). tissue undersurface of the patella, quad tendon, and lateral gutter. The lateral parapatellar approach is an alternative that may reduce the risk of these outcomes. Mary McMahon Date: February 14, 2021 An arthrotomy is a surgery that cuts into a joint.. Minimally invasive parapatellar lateral arthrotomy. The aim of this study was to investigate the effects of the medial parapatellar (MPPa), midvastus (MVa), subvastus (SVa) and lateral parapatellar (LPPa) approaches on regional tissue perfusion of the knee. The lateral approach relies on an atraumatic elevation of the vastus lateralis from the lateral aspect of the distal femur and if required a lateral arthrotomy … Attachment of the tibial saw guide. As with any surgical procedure, exposure is essential.
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