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Keblish's lateral surgical approach enhances patellar tilt in valgus knee arthroplasty.

ABSTRACT: OBJECTIVE:To compare the clinical and radiological outcomes of conventional medial and lateral approaches for total knee replacement in the valgus osteoarthritic knee. METHODS:In this randomized controlled trial, 21 patients with valgus knee osteoarthritis were randomized to total knee replacement through medial or lateral approach. The primary outcome was radiographic patellar tilt. Secondary outcomes were visual analog scale of pain, postoperative levels of hemoglobin, and clinical aspect of the operative wound. RESULTS:There were no differences between the groups regarding other clinical variables. Mean lateral tilt of the patella was 3.1 degrees (SD ± 5.3) in the lateral approach group and 18 degrees (SD ± 10.2) in the medial approach group (p = 0.02). There were no differences regarding the secondary outcomes. CONCLUSION:Lateral approach provided better patellar tilt following total knee replacement in valgus osteoarthritic knee.

SUBMITTER: Tonelli Filho JR

PROVIDER: S-EPMC5198141 | biostudies-literature | 2016 Nov-Dec

REPOSITORIES: biostudies-literature

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Keblish's lateral surgical approach enhances patellar tilt in valgus knee arthroplasty.

Tonelli Filho José Roberto JR Passarelli Marcus Ceregatti MC Brito João Alberto Salles JA Campos Gustavo Constantino GC Zorzi Alessandro Rozim AR Miranda João Batista de JB

Revista brasileira de ortopedia 20161025 6

<h4>Objective</h4>To compare the clinical and radiological outcomes of conventional medial and lateral approaches for total knee replacement in the valgus osteoarthritic knee.<h4>Methods</h4>In this randomized controlled trial, 21 patients with valgus knee osteoarthritis were randomized to total knee replacement through medial or lateral approach. The primary outcome was radiographic patellar tilt. Secondary outcomes were visual analog scale of pain, postoperative levels of hemoglobin, and clini ...[more]

PMID: 28050540

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Project description:IntroductionThe aim of this meta-analysis of comparative studies was to update the current evidence on functional and radiographic outcomes and complications between medial and lateral approaches for total knee arthroplasty (TKA) for valgus knee deformity.Materials and methodsThe PubMed, MEDLINE, Scopus, and the Cochrane Central databases were used to search keywords and a total of ten studies were included. The methodological quality of the included studies was assessed. Data extracted for quantitative analysis included the Knee Society score (KSS), range of motion (ROM), surgical time, hip-knee-ankle angle (HKA), and number and types of complications. Random- and fixed-effect models were used for the meta-analysis of pooled mean differences (MDs) and odds ratios (ORs). The Mantel-Haenszel method was adopted.ResultsA total of 1008 patients were identified, of whom 689 and 319 underwent TKA for valgus knee deformity with lateral and medial approach, respectively. The mean age was 70 ± 9.5 and 67.3 ± 9.6 years for the lateral and medial approaches, respectively. The mean follow-up was 37.8 ± 21.9 and 45.9 ± 26.7 months for the lateral and medial approach groups, respectively. Significantly higher functional outcomes were found for the medial approach, as measured by the postoperative KSS (MD = 1.8, 95% CI [0.48, 3.12], P = 0.007) and flexion ROM (MD = 3.12, 95% CI [0.45, 5.79], P = 0.02). However, both of these differences were lower than the minimal clinically important difference. Comparable surgical time and postoperative HKA angle values (MD = 0.22, 95% CI [- 0.30, 0.75], P = 0.40) between the two surgical approaches were found. The incidence of periprosthetic joint infections, fractures, transient peroneal nerve injuries, and deep vein thrombosis was comparable.ConclusionThis meta-analysis of comparative studies showed that when lateral and medial approaches are used for total knee arthroplasty for valgus knee deformity, comparable functional outcomes in terms of the KSS and ROM, surgical time, and postoperative hip-knee-ankle angle values can be expected. Similar rates of periprosthetic joint infection, fracture, and peroneal nerve injury were also found.Level of evidenceI.Prospero registration number idCRD42023392807.

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Keblish's lateral surgical approach enhances patellar tilt in valgus knee arthroplasty.

Publications

Keblish's lateral surgical approach enhances patellar tilt in valgus knee arthroplasty.

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