Michael D. Ries, MD

In many revision total knee arthroplasty cases, the knee can be exposed through a medial parapatellar approach. However, sometimes lateral patellar retraction during the medial parapatellar approach can put too much tension on the extensor mechanism and, should this happen, there is a risk of avulsion of the tibial tubercle. Therefore, you should consider using one of two extensile exposures in these cases.