Extensile Exposures in Revision and Complex Primary Total Knee Arthroplasty: A Review of Anatomy, Biomechanics, and Techniques

翻修和复杂初次全膝关节置换术中的广泛暴露:解剖学、生物力学和技术综述

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Abstract

Developing adequate exposure when performing a revision total knee arthroplasty is critical to an efficient and safe intraoperative course. Proper planning and knowledge of the relevant anatomy are important when dissecting scar tissue associated with previous trauma or surgery and navigating bone loss. We present a review of the different total knee arthroplasty extensile exposure techniques that have been described in the literature. Specific exposures discussed include the femoral peel, banana peel, medial epicondylar osteotomy, quadriceps snip, tibial tubercle osteotomy, wandering resident, and the V-Y quadricepsplasty with patella turndown. Furthermore, we review the histological healing potential, biomechanical principles that drive post-operative expectations, post-operative rehabilitation protocols, and reported functional outcomes of each technique.

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