title: Lateral subvastus approach with tibial tubercle osteotomy for primary total knee arthroplasty: clinical outcome and complications compared to medial parapatellar approach.
abstract: OBJECTIVE
  The lateral subvastus approach (LSVA) with tibial tubercle osteotomy (TTO) is an alternative approach for total knee arthroplasty (TKA) in selected patients. The aim of this study was to compare clinical outcomes between LSV and medial parapatellar approaches for primary TKA and to investigate incidence of complications related to TTO.
  
  
  METHODS
  A total of 580 patients with primary TKA, meeting the inclusion criteria, were treated at our hospital from February 2006 until February 2013. All patients' data were included in the local arthroplasty register and were followed up 12 months postoperatively. The data set contains: demographic data, the WOMAC score, the KSS as well as knee flexion and complications related to tibial tubercle osteotomy.
  
  
  RESULTS
  The clinical outcome after TKA using the LSVA combined with TTO was comparable with those using the medial standard approach 1 year postoperatively. Four patients (3.8 %) needed a revision due to complications related to tubercle osteotomy.
  
  
  CONCLUSIONS
  The LSVA is thus a viable alternative in cases of primary TKA if technical difficulties with the medial approach are anticipated. Applying precise surgical technique, the LSVA seems to be a safe and reproducible procedure.
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Kantonsspital St. Gallen, 9007, St. Gall, Switzerland. susanne.langen@kssg.ch.
authors.forename: Susanne
authors.initials: S
authors.lastname: Langen
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Kantonsspital St. Gallen, 9007, St. Gall, Switzerland.
authors.forename: Sonja
authors.initials: S
authors.lastname: Gaber
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Kantonsspital St. Gallen, 9007, St. Gall, Switzerland.
authors.forename: Vilijam
authors.initials: V
authors.lastname: Zdravkovic
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Kantonsspital St. Gallen, 9007, St. Gall, Switzerland.
authors.forename: Karlmeinrad
authors.initials: K
authors.lastname: Giesinger
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Kantonsspital St. Gallen, 9007, St. Gall, Switzerland.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Jost
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Kantonsspital St. Gallen, 9007, St. Gall, Switzerland. henrik.behrend@kssg.ch.
authors.forename: Henrik
authors.initials: H
authors.lastname: Behrend
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome
keywords: Lateral approach; Tibial tubercle osteotomy; Total knee arthroplasty