Special Technical ArticlesThe Extensile Medial Parapatellar Approach to the Distal Femur and Knee: Anatomic Landmarks and Surgical TechniqueStevens, Jarrad MBBS, FRACS, FAOrthA; Clement, Nicholas D. FRCSEd (Tr & Orth), PhD; Patton, James T. FRCSEd (Tr & Orth), FRCSAuthor Information Department of Surgery, Orthopaedics, Royal Infirmary Edinburgh, Edinburgh, Scotland, UK The authors declare that they have nothing to disclose. For reprint requests, or additional information and guidance on the techniques described in the article, please contact Jarrad Stevens, MBBS, FRACS, FAOrthA, at email@example.com or by mail at Edinburgh, Scotland, UK. You may inquire whether the author(s) will agree to phone conferences and/or visits regarding these techniques. Techniques in Orthopaedics: June 2019 - Volume 34 - Issue 2 - p 129-133 doi: 10.1097/BTO.0000000000000307 Buy Metrics Abstract This paper describes an extensile surgical approach to the distal femur, which incorporates the medial parapatellar arthrotomy. This extensile exposure serves as an anterior utility approach to the knee, allowing the surgeon access to all aspects of the anterior knee and near circumferential access to the distal femur. Reported indications for access to this region include: tumor resection, difficult primary arthroplasty and revision arthroplasty of the knee, and intra-articular and extra-articular fractures of the distal femur. Despite adequate working knowledge of the standard medial parapatellar approach to the knee, the extensile approach is seldom required and, as a result, orthopedic trainees and practising orthopedic surgeons may not be familiar with the musculotendonous junctions that occur in the quadriceps tendon. This report describes a novel surgical approach and the relevant anatomy through a series of detailed clinical and fresh cadaveric dissections. A previously undescribed anatomic landmark is demonstrated through photographs and cadaveric variation studies, which may help guide the surgeon in defining crucial planes. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.