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Published in: Archives of Orthopaedic and Trauma Surgery 6/2004

01-07-2004 | Original Article

Early results of subvastus versus medial parapatellar approach in primary total knee arthroplasty

Authors: C. Weinhardt, M. Barisic, E. G. Bergmann, K. D. Heller

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 6/2004

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Abstract

Introduction

To evaluate the clinical and radiographic results immediately after total knee arthroplasty, we compared the parapatellar and subvastus approach.

Materials and methods

Fifty-two patients with osteoarthritis were randomly assigned to two groups. The measurement was based on clinical and radiographic features.

Results

There was a significant difference in passive range of motion. Patients in the subvastus approach group revealed a full knee extension and flexion of 90° significantly earlier than those in the parapatellar group. However, on the day of discharge, both groups were comparable. Radiological assessment revealed analogous results in both groups. Correction of varus or valgus deformity was required in 48 patients.

Conclusion

Regardless of the surgical approach, the anteroposterior tibial femoral angle improved significantly in both groups. Concerning pain, operation time, blood loss, blood substitution and complications, no major differences could be seen.
Literature
1.
go back to reference Bach CM, Steingruber IE, Peer S, Nogler M, Wimmer C, Ogon M (2001) Radiographic assessment in total knee arthroplasty. Clin Orthop 385:144–150PubMed Bach CM, Steingruber IE, Peer S, Nogler M, Wimmer C, Ogon M (2001) Radiographic assessment in total knee arthroplasty. Clin Orthop 385:144–150PubMed
2.
go back to reference Bindelglass DF, Vince KG (1996) Patellar tilt and subluxation following subvastus and parapatellar approach in total knee arthroplasty. Implication for surgical technique. J Arthroplasty 11 [Suppl 5]:507–511 Bindelglass DF, Vince KG (1996) Patellar tilt and subluxation following subvastus and parapatellar approach in total knee arthroplasty. Implication for surgical technique. J Arthroplasty 11 [Suppl 5]:507–511
3.
go back to reference Chang CH, Chen KH, Yang RS, Liu TK (2002) Muscle torques in total knee arthroplasty with subvastus and parapatellar approaches. Clin Orthop 398:189–195PubMed Chang CH, Chen KH, Yang RS, Liu TK (2002) Muscle torques in total knee arthroplasty with subvastus and parapatellar approaches. Clin Orthop 398:189–195PubMed
4.
go back to reference Cila E, Guzel V, Ozalay M, Tan J, Simsek SA, Kanatli U, Ozturk A (2002) Subvastus versus medial parapatellar approach in total knee arthroplasty. Arch Orthop Trauma Surg 122:65–68CrossRefPubMed Cila E, Guzel V, Ozalay M, Tan J, Simsek SA, Kanatli U, Ozturk A (2002) Subvastus versus medial parapatellar approach in total knee arthroplasty. Arch Orthop Trauma Surg 122:65–68CrossRefPubMed
5.
go back to reference Faure BT, Benjamin JB, Lindsey B, Volz RG, Schutte D (1993) Comparison of the subvastus and paramedian surgical approaches in bilateral knee arthroplasty. J Arthroplasty 8:511–516PubMed Faure BT, Benjamin JB, Lindsey B, Volz RG, Schutte D (1993) Comparison of the subvastus and paramedian surgical approaches in bilateral knee arthroplasty. J Arthroplasty 8:511–516PubMed
6.
go back to reference Hanssen AD (2002) The subvastus approach for total knee arthroplasty resulted in better short-term outcomes than did the parapatellar approach. J Bone Joint Surg Am 84:325 Hanssen AD (2002) The subvastus approach for total knee arthroplasty resulted in better short-term outcomes than did the parapatellar approach. J Bone Joint Surg Am 84:325
7.
go back to reference Harvey IA, Barry K, Kirby SP, Johnson R, Elloy MA (1993) Factors affecting the range of movement of total knee arthroplasty. J Bone Joint Surg Br 75:950–955PubMed Harvey IA, Barry K, Kirby SP, Johnson R, Elloy MA (1993) Factors affecting the range of movement of total knee arthroplasty. J Bone Joint Surg Br 75:950–955PubMed
8.
go back to reference Hofmann AA, Plaster RL, Murdock LE (1991) Subvastus (Southern) approach for primary total knee arthroplasty. Clin Orthop 269:70–77PubMed Hofmann AA, Plaster RL, Murdock LE (1991) Subvastus (Southern) approach for primary total knee arthroplasty. Clin Orthop 269:70–77PubMed
9.
go back to reference Laubenthal KN, Smidt GL, Kettelkamp DB (1972) A quantitative analysis of knee motion during activities of daily living. Phys Ther 52:34–43PubMed Laubenthal KN, Smidt GL, Kettelkamp DB (1972) A quantitative analysis of knee motion during activities of daily living. Phys Ther 52:34–43PubMed
10.
go back to reference Matsueda M, Gustilo RB (2000) Subvastus and medial parapatellar approaches in total knee arthroplasty. Clin Orthop 371:161–168PubMed Matsueda M, Gustilo RB (2000) Subvastus and medial parapatellar approaches in total knee arthroplasty. Clin Orthop 371:161–168PubMed
11.
go back to reference Menke W, Schmitz B, Salm S (1992) Range of motion after total condylar knee arthroplasty. Arch Orthop Trauma Surg 111:280–281PubMed Menke W, Schmitz B, Salm S (1992) Range of motion after total condylar knee arthroplasty. Arch Orthop Trauma Surg 111:280–281PubMed
12.
go back to reference Ranawat CS (1996) The patellofemoral joint in total condylar knee arthroplasty. Pros and cons based on five- to ten-year follow-up observations. Clin Orthop 205:93–99 Ranawat CS (1996) The patellofemoral joint in total condylar knee arthroplasty. Pros and cons based on five- to ten-year follow-up observations. Clin Orthop 205:93–99
13.
go back to reference Roysam GS, Oakley MJ (2001) Subvastus approach for total knee arthroplasty: a prospective, randomized, and observer-blinded trial. J Arthroplasty 16:454–457PubMed Roysam GS, Oakley MJ (2001) Subvastus approach for total knee arthroplasty: a prospective, randomized, and observer-blinded trial. J Arthroplasty 16:454–457PubMed
14.
go back to reference Schurman DJ, Parker JN, Ornstein D (1985) Total condylar knee replacement. A study of factors influencing range of motion as late as two years after arthroplasty. J Bone Joint Surg Am 67:1006–1014PubMed Schurman DJ, Parker JN, Ornstein D (1985) Total condylar knee replacement. A study of factors influencing range of motion as late as two years after arthroplasty. J Bone Joint Surg Am 67:1006–1014PubMed
Metadata
Title
Early results of subvastus versus medial parapatellar approach in primary total knee arthroplasty
Authors
C. Weinhardt
M. Barisic
E. G. Bergmann
K. D. Heller
Publication date
01-07-2004
Publisher
Springer-Verlag
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 6/2004
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-004-0692-3

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