The knee is a hinge type of synovial joint with three articular sur.rices.The femoral and tibial condyles articulate on the lateral and medial sides,and the patella and femur articulate in between.The quadriceps are the primary extensors of the knee and are in.nervated by the femoral nerve（1，2，3，4）.The hamstrings are the primary flexors ofthe knee and are innervated by branches of the scia nerve（L5，S11.The anterior and posterior cruciate liga.ments are critical in preventing anterior and posterior displacement of the tibia on the femur.The medial andlateral collateral ligaments are vital fof lateral stability of the knee.Although arthroscopic procedures are increasingly the standard of care for many knee operations,there are several open surgical approaches to the knee.The medial parapateuar approach is one of the more common open surgical approaches.Medial Parapatellar Approach The medial parapatellar Surgical approach to the knee provides excehent exposure of most structures and is used for total knee replacement CTKR）.medial meniscectomy,removal of loose bodies,ligamentous reconstruction。as well as other pathologies.The patella is easily palpated superficially.The patellar ligament attaches the inferior border of the patella to the tibial tubercle.
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