A Comparison of Patellar Vascularity Between the Medial Parapatellar and Subvastus Approaches in Total Knee Arthroplasty
Section snippets
Materials and Methods
This study reports the results of a secondary outcome from a larger randomized controlled trial (RCT) investigating the physical and functional outcomes of the MPa and SVa [10] because no previous research has provided empirical data on patellar vascularity from different TKA approaches. The larger RCT was conducted from May 2006 to November 2009, and institutional ethics committee approval was granted for this trial. Written informed consent for all procedures was obtained from each
Results
The 10 participants in the SVa group comprised 3 women and 7 men (mean age, 69.7 years; range, 56-83 years), whereas those in the MPa group included 7 women and 3 men (mean age, 69.8 years; range, 64-86 years). All 20 participants received their allocated surgical approach and participated in the planned postoperative care and rehabilitation. There were no complications, lateral releases, or other contraventions to surgical protocol or follow-up in either group. The raw data for all outcomes is
Discussion
This study found no significant difference between the SVa and MPa for the outcomes of patellar vascularity assessed using radionuclide bone imaging and the clinical BVS. There was also no between-group difference in the mean rating of anterior knee pain at 18 months postoperatively. The hypothesis that the SVa would afford better results for vascularity and anterior knee pain than the MPa because of the extensive dissection of the patellar arterial blood supply in the latter approach was
Acknowledgment
Contributors:
Bone vascularity scale scoring: Dr Peter Jackson, MBBS, FRANZCR.
Data collection: Dr Prudence FitzPatrick, MBBS, FRACS. Tuesday Cole, BNucMed (Hons), GDip (Med Ultrasound). Daniel Kim, MPhty student, University of Queensland. Jade Mitchell, MPhty student, University of Queensland. Peter Rego, MPhty student, University of Queensland. Katherine Schindler, MPhty student, University of Queensland. Lisa Tennant, MPhty student, University of Queensland.
References (19)
- et al.
The relationship of lateral releases to patella viability in total knee arthroplasty
J Arthroplasty
(1987) - et al.
Blood supply to the patella. Significance in total knee arthroplasty
J Arthroplasty
(1989) - et al.
Intraosseous blood flow of the everted or laterally-retracted patella during total knee arthroplasty
Knee
(2007) Bone scintigraphy in the diagnosis and management of traumatic injury
Semin Nucl Med
(1983)- et al.
Diagnosis and management of the osteonecrotic triad of the knee
Orthop Clin North Am
(2004) Australian Orthopaedic Association National Joint Replacement Registry
- et al.
Subvastus (Southern) approach for primary total knee arthroplasty
Clin Orthop
(1991) - et al.
Bone scanning in the assessment of patellar viability following knee replacement
Clin Orthop
(1985) - et al.
Evaluation of patella viability after disruption of the arterial circulation
Am J Sports Med
(1987)
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Supplementary material available at www.arthroplastyjournal.org.
The Conflict of Interest statement associated with this article can be found at doi:10.1016/j.arth.2012.01.013.