title: Equivalent results of medial and lateral parapatellar approach for total knee arthroplasty in mild valgus deformities.
abstract: When performing total knee arthroplasty (TKA) in valgus knee deformities, a medial or lateral parapatellar approach can be performed, but the lateral approach is often considered technically more difficult. The purpose of this study was to compare intra-operative, early clinical and radiological outcomes of medial and lateral parapatellar approaches for TKA in the setting of moderate knee valgus (<10°).
  
  
  
  We prospectively analysed 424 knees with pre-operative valgus deformity between 3° and 10° that underwent TKA over an 18-year period; 109 were treated with a medial approach and 315 with a lateral approach. Intra- and post-operative outcomes and complication rates after a minimum follow-up of one year were compared.
  
  
  
  Tourniquet (p = 0.25) and surgical (p = 0.62) time were similar between groups. The popliteus tendon was released more frequently in the medial-approach group (p = 0.04), while the iliotibial band was released more frequently in the lateral-approach group (p < 0.001). A tibial tuberosity osteotomy was performed more frequently in the lateral- than medial-approach group (p = 0.003). No significant differences in limb alignment (p = 0.78), or Knee Society Score (KSS) knee (p = 0.32) and function (p = 0.47) results were noted based on surgical approach, and complication rates were similar between groups (p = 0.53).
  
  
  
  Lateral parapatellar approach is a safe and effective surgical technique for performing TKA in moderately valgus knees. These equivalent early results are encouraging for systematic use of the lateral approach in moderately valgus knees.
authors.affiliation: Albert Trillat Center, Groupement Hospitalier Nord, Université de Lyon, Lyon, France. stanislas.gunst@hotmail.fr.
authors.forename: Stanislas
authors.initials: S
authors.lastname: Gunst
authors.affiliation: Albert Trillat Center, Groupement Hospitalier Nord, Université de Lyon, Lyon, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Villa
authors.affiliation: Department of Orthopaedic Surgery, The Ohio State University Medical Center, Columbus, OH, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Magnussen
authors.affiliation: Albert Trillat Center, Groupement Hospitalier Nord, Université de Lyon, Lyon, France.
authors.forename: Elvire
authors.initials: E
authors.lastname: Servien
authors.affiliation: Albert Trillat Center, Groupement Hospitalier Nord, Université de Lyon, Lyon, France.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Lustig
authors.affiliation: Albert Trillat Center, Groupement Hospitalier Nord, Université de Lyon, Lyon, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Neyret
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D056304:Genu Valgum / Q000601:surgery*; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010027:Osteotomy / Q000379:methods; D011446:Prospective Studies; D013977:Tibia / Q000601:surgery; D016896:Treatment Outcome
keywords: Lateral approach; Lateral arthrotomy; Tibial tubercle osteotomy; Total knee arthroplasty; Valgus