J Korean Orthop Assoc.  2007 Jun;42(3):354-359. 10.4055/jkoa.2007.42.3.354.

A Comparison of the Midvastus and Median Parapatellar Surgical Approaches in Total Knee Arthroplasty

• Jung WH
• Ha YC
• Cha MS

• KMID: 2186560
• DOI: http://doi.org/10.4055/jkoa.2007.42.3.354

Abstract

PURPOSE: To evaluate the difference between the midvastus and median parapatellar approach in total knee arthroplasty (TKA) in terms of clinical and radiologic results.
MATERIALS AND METHODS
From January to December 2003, 49 patients having bilateral TKA were randomized prospectivity-one knee having a vastus splitting approach and the other knee having a median parapatellar approach- to compare operation time, postoperative ROM and drain amount, knee society knee score and function score, return to SLR, patellar tilting and displacement. The data was collected during 2 years of follow-up period, and analyzed using paired t-test.
RESULTS
The patients with the midvastus splitting approach performed active straight-leg raise sooner (mean, 1.8 day) than the patients operated on using median parapatellar approach (mean, 2.2 days). But, there was no statistically difference. Knee flexion was better at post-operative 4 weeks in midvastus splitting approach group (mean, 125.5 degrees) than the median parapatellar approach group (mean, 123.9 degree)(p=0.028). However, patellar displacement was more severe in midvastus splitting approach group (mean, 3.4 mm) than the median parapatellar group (mean, 1.6 mm) (p=0.035). There was 1 postoperative hematoma and avulsion fracture of patellar tendon in midvastus splitting approach group.
CONCLUSION
Even though midvastus splitting approach could provides the advantage of early postoperative rehabilitation, The midvastus splitting surgical approach dose not consider as being superioir to median parapatellar approach due to severe injury of midvastus and limitation of surgical indication.

Keyword

Total knee arthroplasty; Midvastus splitting approach; Patellar tracking

MeSH Terms

Arthroplasty*
Follow-Up Studies
Hematoma
Humans
Knee*
Patellar Ligament
Rehabilitation

Figure

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  Fig. 1 (A) Patellar tilt and (B) patella displacement were measured from the 45° Merchant view.

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