Lateral Approach to Knee Joint

The lateral approach to knee joint provides access to all the supporting structures on the lateral side of the knee.

1. Exposure for lateral knee ligament repair or reconstruction.
2. Open lateral meniscal tear repair.

• with a sandbag under the buttock of the affected side.
• Knee should be flexed during approach

• Lateral border of patella.
• Gerdy’s tubercle.
  • Marking insertion of ilio-tibial band.

• Make long, curved incision at the lateral border of center of patella.
  • begin 3 cm lateral to edge of patella,
  • end 4-5 cm distal to joint centered over Gerdy’s tubercle.

1. Iliotibial band (ITB):  it’s innervated by the superior gluteal nerve.
2. Biceps femoris tendon: it’s innervated sciatic nerve.

• avoid common peroneal nerve on posterior border of biceps femoris tendon.
• retract ITB anteriorly and biceps tendon posteriorly:
  • exposes superficial lateral collateral ligament (LCL).

• Anterior arthrotomy:
  • exposes entire lateral meniscus.
• Posterior arthrotomy:
  • exposes posterior horn of lateral meniscus and posterolateral corner.

1. Common peroneal nerve:
   • at risk on posterior border of biceps femoris.
2. Popliteal artery:
   • at risk posterior to posterior horn of lateral meniscus.
3. Popliteus tendon:
   • runs within joint adjacent to lateral meniscus.
   • attaches to posterior aspect of meniscus and femur.
   • at risk if performing a posterior arthrotomy.
4. Lateral superior genicular artery:
   •  at risk between femur and vastus lateralis.
5. Lateral inferior genicular artery:
   • at risk between lateral head of gastrocnemius and posterolateral corner.
   • should be ligated.