Comparison of the Patella Medial Approach and Quadriceps Sparing Approach in the Total Knee Arthroplasty

Ji Lei; Tao Weidong

Abstract：Objective To explore and study the effect of different surgical approaches on patellar joint complications and the internal and external tilt movement of patella in total knee arthroplasty. Methods 40 cases of patients with osteoarthritis of the knee joint treated in our hospital from January 2011 to February 2013 were divided into MPA group and SVA group accord-ing to the random digital table method with 20 cases in each group. The MPA group was treated with medial parapatellar ap-proach for total knee arthroplasty,and the SVA group was treated with subvastus approach for total knee arthroplasty. The effects of two kinds of surgical approaches on patellar joint complications and the internal and external tilt movement of patella were compared. Results The replacement time in the MPA group was significantly decreased compared with that in the SVA group,but the length of incision and activity time getting out of bed were much higher than those in the latter,and the differ-ences were statistically significant(P < 0. 05). There were no obvious differences in bleeding volume,postoperative drainage volume between the two groups(P > 0. 05). There were no significant differences in KSS scores and patellar tilt angles between the two groups before and at 1 year and 2 years after operation(P > 0. 05),and the difference was significant in the KSS scores and patellar tilt angles at 30 degrees of flexion of the knee at 3 months after operation(P < 0. 05). The complications rate was 5% in the MPA group,which was 0 in the SVA group,and the difference was not statistically significant(P > 0. 05). Conclu-sion The injury stimulation by subvastus approach for total knee arthroplasty is smaller than that by medial parapatellar ap-proach,and the short-term knee joint function and patellar tilt angle of the former are significantly superior to those of the lat-ter,but there are no significant differences in the long-term efficacy and complications.