Most commonly used, familiar to most surgeons

Excellent exposure

Versatile

Potential disruption of the extensor mechanism

May affect patellar tracking

Preserves the quadriceps tendon

Potential for quicker early recovery

Improved patellar tracking

Technically more demanding

Limited exposure in obese or muscular patients

True quadriceps-sparing approach

Faster rehabilitation and reduced postoperative pain

Limited exposure, especially in stiff or valgus knees

Not suitable for all patients (severe valgus cases)

Direct access to lateral pathology in valgus knees

Facilitates sequential lateral release

Preserves medial soft tissues

Limited access to posteromedial structures

Learning curve

Contraindicated with previous scars or in varus knees