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Lateral subvastus approach with tibial tubercle osteotomy for primary total knee arthroplasty: clinical outcome and complications compared to medial parapatellar approach

Susanne Langen, Sonja Gaber, Vilijam Zdravkovic, Karlmeinrad Giesinger, Bernhard Jost & Henrik Behrend

abstract

PURPOSE
The lateral subvastus approach (LSVA) with tibial tubercle osteotomy (TTO) is an alternative approach for total knee arthroplasty (TKA) in selected patients. The aim of this study was to compare clinical outcomes between LSV and medial parapatellar approaches for primary TKA and to investigate incidence of complications related to TTO.

METHODS
A total of 580 patients with primary TKA, meeting the inclusion criteria, were treated at our hospital from February 2006 until February 2013. All patients' data were included in the local arthroplasty register and were followed up 12 months postoperatively. The data set contains: demographic data, the WOMAC score, the KSS as well as knee flexion and complications related to tibial tubercle osteotomy.

RESULTS
The clinical outcome after TKA using the LSVA combined with TTO was comparable with those using the medial standard approach 1 year postoperatively. Four patients (3.8 %) needed a revision due to complications related to tubercle osteotomy.

CONCLUSIONS
The LSVA is thus a viable alternative in cases of primary TKA if technical difficulties with the medial approach are anticipated. Applying precise surgical technique, the LSVA seems to be a safe and reproducible procedure.
   
citation Langen S, Gaber S, Zdravkovic V, Giesinger K, Jost B, Behrend H. Lateral subvastus approach with tibial tubercle osteotomy for primary total knee arthroplasty: clinical outcome and complications compared to medial parapatellar approach. Eur J Orthop Surg Traumatol 2016;.
   
type journal paper/review (English)
date of publishing 1-2-2016
journal title Eur J Orthop Surg Traumatol
ISSN electronic 1633-8065
PubMed 26567166
DOI 10.1007/s00590-015-1718-y
contact Henrik Behrend