Total Diz Artroplastisinde Midvastus Yaklaşımına Karşılık Medial Parapatellar Yaklaşım: Erken Fonksiyonel Sonuçların Karşılaştırılması

Abstract

Objective: The purpose of this study was to compare the early outcomes of total knee arthroplasty (TKA) using midvastus (MV) versus medial parapatellar (MPP) approaches on both knees. Material and Methods: Fifty two consecutive patients (104 knees) who underwent single-stage bilateral TKA performed by two surgeons between August 2004 and December 2007 were evaluated retrospectively at a minimum follow-up duration of two years. Patients were divided into two groups. In the MV group, consisted of 27 patients, a midvastus approach was performed on both knees. Besides, in the MPP group, consisted of 25 patients, a medial parapatellar approach was performed on both knees. Results: Mean follow-up duration was 40.2 months (27-66 months) and 42.3 months (25-61 months) for the MV and MPP groups, respectively. The Knee Society Clinical Rating System (knee and function score), the range of motion, patellofemoral pain questionnaire, patient satisfaction questionnaire and radiography were used for the evaluation of both groups. Lateral retinacular release (LRR) was performed on four knees in the MPP group whereas it was not used in the MV group. There was a significant difference between the two groups with regard to the rate of LRR (p= 0.034). Axial radiographs revealed that six patellas in the MPP group, but only one in the MV group exhibited lateral displacement postoperatively (p= 0.039). Conclusion: The preservation of normal patellar tracking is important for TKA. In this study, the midvastus approach required significantly less LRR as compared to the medial parapatellar approach.