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 w...

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Published inThe Journal of arthroplasty Vol. 27; no. 6; pp. 1123 - 1127.e1
Main Authors Bourke, Michael G., BPhty, Sclavos, Eric K., MBBS, FRANZCR, Jull, Gwendolen A., PhD, MPhty, FACP, Buttrum, Peter J., BPhty, Dalton, Philip A., BPhty (Hons), MMedSc, MBBS (Hons), FRACS CIME, Russell, Trevor G., PhD, BPhty
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.06.2012
Subjects
Aged
Aged, 80 and over
Arthralgia - epidemiology
Arthralgia - etiology
arthroplasty
Arthroplasty, Replacement, Knee - adverse effects
Arthroplasty, Replacement, Knee - methods
avascular necrosis
Diagnostic Imaging
Female
Femur - diagnostic imaging
Femur - surgery
Humans
knee
Knee Joint - diagnostic imaging
Knee Joint - surgery
Male
medial parapatellar
Middle Aged
Orthopedics
Osteoarthritis, Knee - surgery
Osteonecrosis - epidemiology
Osteonecrosis - etiology
Patella - blood supply
Patella - diagnostic imaging
Radionuclide Imaging
Regional Blood Flow
replacement
Risk Factors
subvastus
Treatment Outcome
knee
CT
arthroplasty
subvastus
avascular necrosis
replacement
medial parapatellar
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Summary: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.
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SourceType-Scholarly Journals-1
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ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2012.01.013