title: [Lateral approach to the knee combined with an osteotomy of the tibial tuberosity. Its use for total knee replacement].
abstract: OBJECTIVE
  Simple standard approach to the knee for implantation of a total knee prosthesis.
  
  
  METHODS
  Insertion of a total knee prosthesis.
  
  
  METHODS
  Existing scars from medial or median approaches to the knee. The distance between old scar and planned incision should never be less than 5 cm.
  
  
  METHODS
  Lateral parapatellar approach with judicious detachment of the iliotibial tract from Gerdy's tubercle. Opening of the compartment of tibialis anterior muscle. Mobilization of the patellar ligament together with Hoffa's fat pad in a medial direction. Osteotomy of the tibial tuberosity. Retraction of the distal part of the quadriceps, the patella, the patellar ligament and the tibial tuberosity medially, taking care not to detach the soft tissue from the medial side of the tuberosity. After insertion of the components refixation of the tibial tuberosity with two 3.5-mm cortical screws using the lag screw principle.
  
  
  METHODS
  Unrestricted functional treatment possible starting day 1.
  
  
  RESULTS
  Since 1990 we implanted 702 tokal knee prostheses using the described approach. In 99% of the patients the osteotomy consolidated during the first 3 months without formation of a callus. Complications attributable to the osteotomy of the tuberosity were encountered in 7 patients (1%).
authors: Klinik für Orthopädische Chirurgie und Traumatologie des Bewegungsapparates, Kantonsspital Bruderholz, CH-4101, Bruderholz, Schweiz. arnold_mp@hotmail.com.
authors: M P
authors: MP
authors: Arnold
authors: Klinik für Orthopädische Chirurgie und Traumatologie des Bewegungsapparates, Kantonsspital Bruderholz, CH-4101, Bruderholz, Schweiz.
authors: N F
authors: NF
authors: Friederich
authors: H
authors: H
authors: Widmer
authors: Klinik für Orthopädische Chirurgie und Traumatologie des Bewegungsapparates, Kantonsspital Bruderholz, CH-4101, Bruderholz, Schweiz.
authors: W
authors: W
authors: Müller
keywords: Lateral approach to the knee; Osteotomy of the tibial tuberosity; Subvastus approach; Total knee replacement