The authors describe a lateral approach to the knee associated with a tibial tubercle osteotomy and a plasty using the fat pad to provide a complete closure of the wound. This lateral approach has been performed successfully in 98 cases, with only 3 skin necrosis. It offers a large exposure of the joint, facilitates placement of tibial component trial fit, and allows the self centering of the quadriceps patellar-tendon mechanism at the end of the intervention. The lateral approach disputable in case of genu varum is recommended in all cases of genu valgum or important deformities.

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