title: Time dependent changes in patellar tracking with medial parapatellar and midvastus approaches.
abstract: The aim of this study was to compare the alteration of patellar tracking by time, which was performed through two different approaches: midvastus and medial parapatellar. Twenty-one patients undergoing simultaneous bilateral primary total knee replacements were randomized prospectively to perform the surgery via a medial parapatellar approach on one knee and midvastus approach on the other knee. All of the patellae were resurfaced. Preoperative, early and late postoperative (mean 22 month) skyline views of the patellae were taken. We found that preoperative 2.24 degrees lateral tilt of patella had not changed by time at the midvastus side (2.95 degrees and 2.57 degrees ). Moreover, preoperative 0.48% lateral subluxation of the patella for midvastus approach had not changed (1.48% and 1.67%). Although 2.19 degrees patellar lateral tilt had not significantly changed at the early postoperative period, which was performed via medial parapatellar approach, there had been a significant increase to 5.38 degrees by time (P=0.037) compared to the preoperative radiographs. Additionally, the preoperative lateral subluxation of the patella (0.57%) at the medial parapatellar side had increased to 5.43% at the early (P=0.009) and 5.62% at the late (P=0.012) postoperative measurements. Midvastus approach is superior to medial parapatellar approach concerning the late patellar tracking.
authors.affiliation: Department of Orthopedics and Traumatology, Adana Medical Center, Baskent University School of Medicine, Adana, Turkey. gurkanozkoc@hotmail.com
authors.forename: Gurkan
authors.initials: G
authors.lastname: Ozkoc
authors.forename: Murat Ali
authors.initials: MA
authors.lastname: Hersekli
authors.forename: Sercan
authors.initials: S
authors.lastname: Akpinar
authors.forename: Metin
authors.initials: M
authors.lastname: Ozalay
authors.forename: Mustafa
authors.initials: M
authors.lastname: Uysal
authors.forename: Necip
authors.initials: N
authors.lastname: Cesur
authors.forename: Reha N
authors.initials: RN
authors.lastname: Tandogan
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging*; D007719:Knee Joint / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010329:Patella / Q000000981:diagnostic imaging*; D011184:Postoperative Period; D011300:Preoperative Care; D011446:Prospective Studies; D011859:Radiography