Lateral approach to the stifle joint

To perform a lateral approach to the stifle joint, the patient is positioned in lateral recumbency. This approach is used for stifle arthrotomies, extracapsular lateral suture, and lateral imbrication of the joint capsule.
An incision is made from the distal third of the femur to the proximal third of the tibia. After making a curved incision, atraumatic dissection of the subcutaneous tissue is performed. The aponeurosis of the biceps femoris is exposed. The joint is incised by palpating the patellar tendon and making an atraumatic incision lateral to this. The synovial membrane is located through dissection. The stifle is rotated externally, and the patella is dislocated. The area is exposed completely, and a small incision is made in the vastus lateralis. A Gelpi retractor is used to maintain the medial dislocation of the patella and expose the femoral trochlea. The lateral and medial aspects, along with the trochlear groove, can now be visualised. A Senn-Miller retractor can be used on the infrapatellar fat pad to access the cruciate ligaments. To close the joint, the retractors are removed, the patella is put back into position, and the joint capsule is closed (in one or two layers depending on level of inflammation). Finally, the subcutaneous layer and the skin are closed.