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Equivalent results of medial and lateral parapatellar approach for total knee arthroplasty in mild valgus deformities

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Abstract

Purpose

When performing total knee arthroplasty (TKA) in valgus knee deformities, a medial or lateral parapatellar approach can be performed, but the lateral approach is often considered technically more difficult. The purpose of this study was to compare intra-operative, early clinical and radiological outcomes of medial and lateral parapatellar approaches for TKA in the setting of moderate knee valgus (<10°).

Methods

We prospectively analysed 424 knees with pre-operative valgus deformity between 3° and 10° that underwent TKA over an 18-year period; 109 were treated with a medial approach and 315 with a lateral approach. Intra- and post-operative outcomes and complication rates after a minimum follow-up of one year were compared.

Results

Tourniquet (p = 0.25) and surgical (p = 0.62) time were similar between groups. The popliteus tendon was released more frequently in the medial-approach group (p = 0.04), while the iliotibial band was released more frequently in the lateral-approach group (p < 0.001). A tibial tuberosity osteotomy was performed more frequently in the lateral- than medial-approach group (p = 0.003). No significant differences in limb alignment (p = 0.78), or Knee Society Score (KSS) knee (p = 0.32) and function (p = 0.47) results were noted based on surgical approach, and complication rates were similar between groups (p = 0.53).

Conclusions

Lateral parapatellar approach is a safe and effective surgical technique for performing TKA in moderately valgus knees. These equivalent early results are encouraging for systematic use of the lateral approach in moderately valgus knees.

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Authors and Affiliations

  1. Albert Trillat Center, Groupement Hospitalier Nord, Université de Lyon, Lyon, France

    Stanislas Gunst, Vincent Villa, Elvire Servien, Sebastien Lustig & Philippe Neyret

  2. Department of Orthopaedic Surgery, The Ohio State University Medical Center, Columbus, OH, USA

    Robert Magnussen

Authors
  1. Stanislas Gunst
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  2. Vincent Villa
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  3. Robert Magnussen
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  4. Elvire Servien
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  5. Sebastien Lustig
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  6. Philippe Neyret
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Correspondence to Stanislas Gunst.

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Gunst, S., Villa, V., Magnussen, R. et al. Equivalent results of medial and lateral parapatellar approach for total knee arthroplasty in mild valgus deformities. International Orthopaedics (SICOT) 40, 945–951 (2016). https://doi.org/10.1007/s00264-015-2893-5

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  • DOI: https://doi.org/10.1007/s00264-015-2893-5

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