Thesis Format
Integrated Article
Degree
Master of Science
Program
Surgery
Supervisor
Lanting, Brent A.
2nd Supervisor
Teeter, Matthew G.
Co-Supervisor
3rd Supervisor
Willing, Ryan
Co-Supervisor
Abstract
The current gold standard surgical approach for Total Knee Arthroplasty (TKA) is a medial parapatellar approach (MPA). We aimed to study a novel lateral subvastus lateralis approach (SLA) for TKA and compare patient outcomes and joint kinematics to the MPA.
Patients with neutral or varus alignment undergoing primary TKA were recruited to undergo the SLA. At one year postoperative, patient outcomes (WOMAC, SF-12, KSS) and joint kinematics (using radio stereometric analysis (RSA)) were analyzed. 7 LPA and 7 MPA patients were compared.
The SLA resulted in improved medial femoral rollback early in flexion, but less “regular” (external) rotation of the femur with respect to the tibia, as compared to the MPA. Patient outcomes were similar between groups.
The SLA may be a viable alternative to the MPA in TKA. Further studies are required to identify any benefits.
Summary for Lay Audience
Total knee arthroplasty (TKA), or joint replacement, is the gold standard treatment for osteoarthritis of the knee. In conventional TKA, the joint is entered medial to the patella, or “kneecap” (MPA). We aimed to study a novel lateral subvastus lateralis approach (SLA) which spares the medial soft tissues.
Seven patients underwent the SLA and seven patients underwent the MPA. At one year from surgery, the motion of the joint was analyzed using radio stereometric analysis (RSA) and patient outcomes were measured using validated scoring forms.
There was no significant difference in patient outcomes between the surgical approaches. The SLA resulted in perhaps more anatomic motion of the knee early in flexion with respect to the femur rolling back on the tibia, but also less anatomic rotation.
The SLA may be a viable alternative to the MPA in TKA. Further studies are required to identify any benefits.
Recommended Citation
Sidhu, Sahil Prabhnoor S., "Lateral Subvastus Lateralis Versus Medial Parapatellar Approach for Total Knee Arthroplasty" (2020). Electronic Thesis and Dissertation Repository. 7444.
https://ir.lib.uwo.ca/etd/7444
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