Efficacy and Mid Term Results of Lateral Parapatellar Approach Without Tibial Tubercle Osteotomy for Primary Total Knee Arthroplasty in Fixed Valgus Knees

Satish, Bhava R.J.; Ganesan, Jutty C.; Chandran, Prakash; Basanagoudar, P.; Balachandar, Damodharasamy

doi:10.1016/j.arth.2013.04.037

Cited by 22 publications

(14 citation statements)

References 23 publications

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“…The lateral parapatellar approach described by Keblish 2 allows for a better exposure of the lateral and posterolateral structures, which are contracted in valgus deformities and should be released for proper ligament balance; it also has the advantage of including the release of lateral patellar retinaculum, which is necessary in most cases with valgus deformity 2, 8…”

Section: Introductionmentioning

confidence: 99%

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Keblish's lateral surgical approach enhances patellar tilt in valgus knee arthroplasty

Filho

Passarelli

Brito

et al. 2016

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveTo compare the clinical and radiological outcomes of conventional medial and lateral approaches for total knee replacement in the valgus osteoarthritic knee.MethodsIn this randomized controlled trial, 21 patients with valgus knee osteoarthritis were randomized to total knee replacement through medial or lateral approach. The primary outcome was radiographic patellar tilt. Secondary outcomes were visual analog scale of pain, postoperative levels of hemoglobin, and clinical aspect of the operative wound.ResultsThere were no differences between the groups regarding other clinical variables. Mean lateral tilt of the patella was 3.1 degrees (SD ± 5.3) in the lateral approach group and 18 degrees (SD ± 10.2) in the medial approach group (p = 0.02). There were no differences regarding the secondary outcomes.ConclusionLateral approach provided better patellar tilt following total knee replacement in valgus osteoarthritic knee.

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Section: Introductionmentioning

confidence: 99%

“…Although some authors recommend the use of the lateral access route in cases of fixed valgus deformities of the knee,8, 9 there is no consensus in the literature regarding the best approach for total arthroplasties in valgus knees 8, 10…”

Section: Introductionmentioning

confidence: 99%

Keblish's lateral surgical approach enhances patellar tilt in valgus knee arthroplasty

Filho

Passarelli

Brito

et al. 2016

Revista Brasileira de Ortopedia (English Edition)

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“…Particularly, it may be due to additional release of lateral soft tissue structures jeopardizing patellar blood supply. 34 Multiple previous studies 5 6 7 8 9 10 11 had described lateral parapatellar and subvastus approaches for valgus knees. Moreover, one advantage of lateral approach is that it can directly address the disturbed pathoanatomy of valgus knee.…”

Section: Discussionmentioning

confidence: 99%

“…Median parapatellar approach is most commonly used approach in TKA including valgus knees. Several studies 5 6 7 8 9 10 had demonstrated the use of lateral capsular approach and modified lateral capsular approach with repositioning of vastus lateralis or tibial tubercle osteotomy (TTO). In addition, a lateral Subvastus 11 12 approach has been described, but it may require snip of vastus lateralis obliquus 11 or TTO 12 to shift the patella medially.…”

Section: Introductionmentioning

confidence: 99%

Total knee arthroplasty in valgus knees using minimally invasive medial-subvastus approach

Shah

Jain

2016

IJOO

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Background:An ideal approach for valgus knees must provide adequate exposure with minimal complications due to approach per se. Median parapatellar approach is most commonly used approach in TKA including valgus knees. A medial subvastus approach is seldom used for valgus knees and has definite advantages of maintaining extensor mechanism integrity and minimal effect on patellar tracking. The present study was conducted to evaluate outcomes of total knee arthroplasty (TKA) and efficacy of subvastus approach in valgus knees in terms of early functional recovery, limb alignment and complications.Materials and Methods:We retrospectively reviewed 112 knees with valgus deformity between January 2006 and December 2011. All patients were assessed postoperatively for pain using Visual Analog Scale (VAS) and quadriceps recovery in form of time to active straight leg raising (SLR) and staircase competency and clinical outcomes using American Knee Society (AKS) score and radiographic evaluation with average followup of 40 months (range 24–84 months).Results:The mean VAS on postoperative day (POD) 1 and POD2 at rest was 2.73 and 2.39, respectively and after mobilization was 3.28 and 3.08, respectively (P < 0.001). The quadriceps recovery was very early and 92 (86.7%) patients were able to do active SLR by POD1 with mean time of 21.98 h while reciprocal gait and staircase competency was possible at 43.05 h. The AKS and function score showed significant improvement from preoperative mean score of 39 and 36 to 91 and 79 (P < 0.001), respectively, and the mean range of motion increased from 102° preoperatively to 119° at recent followup (P < 0.001). The mean tibiofemoral valgus was corrected from preoperative 16° (range 10°–35°) to 5° (range 3°–9°) valgus (P < 0.001).Conclusions:Mini-subvastus quadriceps approach provides adequate exposure and excellent early recovery for TKA in valgus knees, without increase in incidence of complications.

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“…Infrequently, persistence of genu valgus from childhood may exist secondary to metabolic disorders, such as rickets and renal osteodystrophy [7]. Overwhelmingly, the most common etiology of VD knees is primary osteoarthritis and secondly rheumatoid arthritis and posttraumatic arthritis, whereas other inflammatory disorders and osteonecrosis are scarce etiologies based on the main clinical series that utilized TKA in the last two decades [1][2][3][4][5][8][9][10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Primary Total Knee Arthroplasty in Valgus Deformity

Dimitrios¹,

George²,

Ioannis³

2018

Primary Total Knee Arthroplasty

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Proper limb and component alignments as well as soft tissue balance are vital for the longevity and optimal long-term outcomes of total knee arthroplasty (TKA). The majority of orthopedic surgeons agree that the total arthroplasty procedure in valgus knees with a deformity of more than 10° is technically demanding and may prove challenging. At the time of operation, the bone and soft tissue abnormalities that should be corrected make accurate axis restoration, correct component positioning and joint stability attaining a difficult task. Specific pathologic anatomic changes associated with valgus knee should be understood preoperatively and estimated so as to select the proper surgical method, to enhance component position and to restore soft-tissue balancing. The purpose of this chapter is to consider all the valgus knee anatomical variations, to analyze the best preoperative planning and to evaluate the type of implant, constrained or not. Lastly, it will also be underlying the current main approaches and techniques to be proposed in the literature for both bone cuts and soft tissue management of valgus knees and if minimally invasive techniques can be performed in severe deformed knees.

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Efficacy and Mid Term Results of Lateral Parapatellar Approach Without Tibial Tubercle Osteotomy for Primary Total Knee Arthroplasty in Fixed Valgus Knees

Cited by 22 publications

References 23 publications

Keblish's lateral surgical approach enhances patellar tilt in valgus knee arthroplasty

Keblish's lateral surgical approach enhances patellar tilt in valgus knee arthroplasty

Total knee arthroplasty in valgus knees using minimally invasive medial-subvastus approach

Primary Total Knee Arthroplasty in Valgus Deformity

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