From the Research
Muscles Exposed During a Patellar Incision
- The muscles exposed during a patellar incision include the vastus medialis oblique, as mentioned in the study 1.
- The quadriceps muscle is also involved, as seen in the quadriceps sparing approach used in some total knee arthroplasty (TKA) procedures 2.
Vessels Exposed During a Patellar Incision
- The popliteal vascular bundle is at risk of injury during a patellar incision, with an average distance of 8.8 cm from the patellar margin 1.
- The superior and inferior lateral genicular arteries supply blood to the lateral patella and can be severed during lateral release, leading to avascular necrosis of the patella 3.
- The supreme genicular, medial and lateral superior genicular, and medial and lateral inferior genicular arteries form a peripatellar anastomotic ring that supplies the intraosseous patellar system 4.
- The transverse infrapatellar artery also branches off the lateral inferior genicular artery to supply the inferior half of the patella 3.
Key Considerations for Patellar Incision
- Careful soft tissue management is necessary to preserve key vascular structures and maintain the intraosseous vascular supply to the patella 4.
- The position of the patella can influence soft tissue balance measurements during total knee arthroplasty, and surgeons should be aware of this influence during surgical exposure 2.
- A minimally invasive approach can add to exposure difficulties, and specialized techniques such as the soft tissue envelope technique may be necessary to achieve adequate exposure 5.