title: A comparison of patellar vascularity between the medial parapatellar and subvastus approaches in total knee arthroplasty.
abstract: A complication of total knee arthroplasty is patellar avascular necrosis. Surgical approaches for total knee arthroplasty include the medial parapatellar approach (MPa) and, less commonly, the subvastus approach (SVa). The argument that SVa retains better patellar vascularity than the MPa was investigated on 20 participants, (SVa, n = 10; MPa, n = 10) 18 months postoperatively. Outcomes were a radionuclide bone imaging technique, a new bone vascularity scale, and an anterior knee pain numerical assessment scale. Results indicated no significant difference between groups on imaging (P = .935), the components of the bone vascularity scale, or anterior knee pain (P > .999). The SVa appears to offer no benefit over the MPa in terms of patellar vascularity or anterior knee pain.
authors.affiliation: Department of Physiotherapy, QEII Jubilee Hospital, Queensland Health, Brisbane, Queensland, Australia.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Bourke
authors.forename: Eric K
authors.initials: EK
authors.lastname: Sclavos
authors.forename: Gwendolen A
authors.initials: GA
authors.lastname: Jull
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Buttrum
authors.forename: Philip A
authors.initials: PA
authors.lastname: Dalton
authors.forename: Trevor G
authors.initials: TG
authors.lastname: Russell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000453:epidemiology* / Q000209:etiology; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods*; D003952:Diagnostic Imaging; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010020:Osteonecrosis / Q000453:epidemiology* / Q000209:etiology; D010329:Patella / Q000098:blood supply* / Q000000981:diagnostic imaging; D011877:Radionuclide Imaging; D012039:Regional Blood Flow; D012307:Risk Factors; D016896:Treatment Outcome