Source
Insall Scott Key Institute for Orthopaedics & Sports Medicine, Beth Israel Medical Center-Singer Division, New York, NY 10128, USA.
Abstract
To do a successful total knee arthroplasty (TKA), adequate exposure of the tibial plateau and distal femur is required. Difficulty with exposure often is encountered in the patient with a stiff or ankylosed knee. This can lead to complications including component malpositioning and extensor mechanism problems, such as patellar tendon rupture. In these cases where the knee has limited motion preoperatively, knowledge of advanced techniques for soft tissue treatment, and for optimizing exposure are required. Numerous such techniques have been described, including the quadriceps snip, V-Y quadriceps turndown, tibial tubercle osteotomy, and femoral peel. A systematic review of these techniques, including indications and results, based published reports and our experiences, is presented.