Anterolateral incision in total knee arthroplasty: is there a role for a longer incision in this day-and-age of minimal invasive surgery?

Abstract

Study design

Prospective randomised study on the early clinical outcome of anterior midline versus anterolateral incision for total knee arthroplasty (TKA).

Purpose

To assess the early clinical outcome of anterior midline versus anterolateral incision for TKA in terms of wound dehiscence, time for wound healing, lateral flap numbness and knee range of movements.

Method

A total of 40 consecutive patients randomly received either anterior midline (midline group; 20 patients, 25 TKAs) or anterolateral skin incision (anterolateral group; 20 patients, 24 TKAs) followed by anteromedial arthrotomy. Postoperatively, the patients were assessed for wound dehiscence, time for wound healing, lateral flap numbness and range of movements.

Results

Midline group demonstrated more wound dehiscence, longer healing time and lateral flap numbness compared to anterolateral group. Although the incision was shorter in midline group(P < 0.0001), better flexion was achieved in anterolateral (P < 0.0001).

Conclusion

Anterolateral incision may be superior in terms of wound healing, lateral flap numbness and knee range of movements and may be a good alternative to the routine anterior midline incision especially in patients who want to kneel, for religious reasons, in the early postoperative period.