The distal femur is then visualized, allowing for plate application or intramedullary nailing depending on the fracture pattern. Orthopedic surgeons also utilize this approach for high tibial osteotomy correction, particularly when precise medial compartment unloading is required, and for accessing the distal femur during vascularized bone graft procedures.
Medial Approach Indications for Total Knee Arthroplasty and Surgical Techniques
Key landmarks include the saphenous nerve and vein, which run just beneath the subcutaneous tissue, and the gracilis tendon, which serves as a critical superficial guide to the deeper structures. The plane between the sartorius, gracilis, and semitendinosus muscles provides access to the distal femur while preserving the vascular supply entering from the medial femoral condyle.
Careful hemostasis and layered closure are essential preventative measures. Indications include open reduction and internal fixation of medial femoral condyle fractures, complex distal femoral fractures involving the joint line, and revision surgery where previous implants obstruct the lateral path.
Medial Approach Indications for Total Knee Arthroplasty and Beyond
Weight-bearing is typically limited based on the stability of the fixation, with partial weight-bearing often prescribed for fracture cases. The incision typically begins just distal to the medial joint line, following the medial parapatellar or periarticular plane.
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