Lateral Approach to the Knee

Lateral approach to the knee through an incision along the iliotibial band that curves distally towards Gerdy tubercle, between the fibular
Lateral approach to the knee through an incision along the iliotibial band that curves distally towards Gerdy tubercle, between the fibular head and the tibial tubercle. Image from Cabarcas B, Patel R, Mahler R, Kumar N, Warnick D. Anatomic Posterolateral Corner Reconstruction With Single Tibialis Allograft and Suspensory Tibial Fixation. Arthrosc Tech. 2025, 14(3), 103265. CC BY 4.0.
Lateral view of the knee joint
Lateral view of the knee joint. The lateral approach passes near the iliotibial band, lateral collateral ligament and common peroneal nerve. Image by DataBase Center for Life Science (DBCLS), Wikimedia Commons, CC BY 4.0.

Position

  • supine
  • sandbag under buttock
  • flex knee to 90°
  • foot rest
  • lateral support

Landmarks

  • Lateral border of patella
  • Lateral joint line
  • Gerdy’s tubercle
    • Inferior attachment of iliotibial band

Incision

  • Curved longitudinal incision
  • Start: Level of the middle of the patella & 3 cm lateral to it
  • Over Gerdy’s tubercle
  • End: 5 cm distal to the joint line

Internervous Plane

  • Iliotibial band
  • Biceps femoris

Superficial Dissection

  • Mobilise skin flaps
  • Identify & develop the plane between
    • Iliotibial band
      • Attaches to Gerdy’s tubercle
    • Biceps femoris
      • Head of fibula
  • Incise the fascia between them being careful of
  • Exposes superficial lateral ligament

Deep Dissection

  • Enter the joint either in front or behind the superficial lateral ligament
  • Anterior arthrotomy
    • Lateral parapatellar approach
    • Begin 2cm above the joint line to avoid incising the meniscus
  • Posterior arthrotomy
    • Identify
      • Lateral head of gastrocnemius
      • Lateral superior geniculate artery
        • Ligated
      • Popliteus tendon
      • Posterolateral corner
    • Longitudinal incision in capsule
      • Starting above the joint line to avoid cutting the meniscus or popliteus

Dangers

  • Nerve
  • Vessels
    • Lateral superior geniculate artery
      • Between lateral head of gastrocnemius & posterolateral capsule
  • Popliteus tendon

Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.