Fig. 1

These steps follow the removal of the skin and subcutaneous tissue. a In a superior approach, the quadriceps tendon is cut about 5 cm above the patella. The incision is followed along the sides of the tendon until the menisci. b The patella is resected, and subsequently detached by a horizontal incision through the patellar tendon at the level of the infrapatellar fat pad (IPFP). c The posterior/articulating portion of the patella is preserved to assess osteoarthritis. d The ligament here is identified as separate, and the attachments (intercondylar notch (ICN), and the IPFP) can clearly be seen