Place the patient supine on a radiolucent table. A small bolster can be placed beneath the buttock to prevent external rotation of the lower extremity.
Supine position on a split table
The supine position on a split table fully extends the knee and relaxes the knee extensor muscles. This is useful when vastus lateralis has to be retracted forwards. It is also the position of choice for patellar fractures and disruptions of the extensor mechanism.
Supine - unilateral leg support
The supine position with unilateral leg support offers excellent image intensifier access for the lateral views. It also allows the surgeon to vary the degree of flexion of the knee at different stages of the procedure. A surgical assistant is needed to hold the lower leg in the correct position throughout the operation.
Supine position knee flexed 90°
In the supine position with the knee flexed 90° it is fully supported, which helps the surgeon who has little, or no, intraoperative assistance. It tightens the extensor muscles and limits vastus lateralis retraction. It is well suited to procedures requiring lateral patellar dislocation. Beware prolonged pressure on the popliteal neurovascular bundle.
Supine position for arthroscopy
Place the patient supine on the operation table. Use a thigh support to bring the knee into flexion of at least 30°.
The prone position is used for posterior approaches to the popliteal area, or for the repair of posterior wounding, neurovascular surgery, etc.