Anterolateral approach to the proximal tibia
1. Skin incision
Make a straight incision lateral to the patella.
2. Opening the fascia
Open the deep fascia anterior to the ilio-tibial tract.
Release the proximal attachment of the tibialis anterior muscle. If necessary release the ilio-tibial tract by incising it or taking a small flake of bone from Gerdy’s tubercle.
Avoid the peroneal nerve which runs posterior to the biceps femoris tendon at its attachment to the fibular head.
Caution
Do not attempt to expose the postero-medial side of the tibia from the antero-lateral approach.
3. Opening the joint
To expose the joint make a horizontal capsulotomy between the deep edge of the meniscus and the tibia. At the time of closure re-attachment of the meniscus and capsule is mandatory.
4. Wound closure
Close the ilio-tibial band and if necessary reattach the Gerdy’s tubercle. Do not close the fascia to avoid a compartment syndrome. Close the remaining soft tissues in a routine manner.
