The surgery is performed in the classical manner with a long anterior skin flap. The patella is ordinarily not disturbed. The condyles of the femur are not shaved nor rounded unless unusually prominent. The synovium is not removed. The articular cartilage on the distal femur is not disturbed.
Postsurgical drainage is essential.
The resulting stump is strong with good quadriceps and hamstring muscle power. The somewhat bulbous terminal bony portion of the stump resulting from the contours of the condyles and patella can be easily managed by a flexible prosthetic insert. 122 Patellar tendon and hamstring muscles sutured under tension in the intercondylar notch. 123 Schematic drawing of Figure 122. 124 Anterior skin flap trimmed to appropriate length.