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    "description": "ObjectiveApproach to the knee for total knee arthroplasty with the goal to avoid tendency to lateralization and extension lag.IndicationsImplantation of total knee components.Revision surgery after total knee arthroplasty.ContraindicationsMorbid obesity.For revision surgery: preoperative knee flexion of <60\u00b0.Surgical TechniqueAnterior midline incision, blunt separation of the distal part of the obliquely running fibers of the vastus medialis over an extent of at least 5 cm. The muscle incision ends at the proximal and medial corner of the patella and is continued distally along the medial patellar border ending at the tibial tuberosity. After opening of the joint, the patella is dislocated laterally thus exposing the articular surfaces. After insertion of the components, superficial adaptation of the muscle fibers and wound closure in layers.ResultsOf 297 total knee implants 276 knees (92.9%) could be followed up for an average of 36.2 (19\u201356) months. 153 knees were in women and 123 in men with an average age of 66.3 (33\u201381) years. In none of the operations a lateral release became necessary. The results were based on the score of the American Knee Society. The score showed 52.3 points preoperatively and 90.6 at follow-up. 95% of the patients had an excellent or good functional result. Tangential radiographs of the patella with the knee in 30\u00b0 of flexion showed in 91% a central position in the patellar groove.", 
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