A and B, Subvastus approach involves lifting entire extensor mechanism off medial intermuscular septum and subluxing it laterally for exposure. C, Tine retractor placed over top of femur and secured on lateral surface places vastus medialis under tension while muscle attachment to intermuscular septum is sharply detached with scissors. D, Complete release of quadriceps to medial intermuscular septum. Exposure obtained after full eversion of patella.