Artikel
The osteoarthritic fixed valgus knee: medial or lateral surgical approach? A prospective study
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Autoren
Veröffentlicht: | 19. Oktober 2004 |
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Gliederung
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Introduction
The surgical approach to the fixed valgus knee for total knee arthroplasty is still controversial. Overall the medial approach is more commonly used,since the lateral approach is technically more demanding and usually includes an osteotomy of the tibial spine. The purpose of this study was to analyze the functional outcome of TKA patients with regard to the approach used.
Methods
100 consecutive patients with an osteoarthritic fixed valgus knee were treated with TKA. Surgeon A used the medial approach without osteotomy of the tibial spine, whereas surgeon B used the lateral approach with osteotomy of the tibial spine. The minimum follow up after surgery was one year. Results were obtained from the IDES (Internat. Documentation & Evaluation System) forms, including the Knee Society Score (KSS), and from the newly developed SEQ (Standard Evaluation Questionnaire), including SF-36 and WOMAC. Descriptive statistics were obtained using StatView.
Results
The knee score was 92.6 in group A and 96.2 in group B, the function score 83.7 and 86.8 respectively. Both scores were slightly better with the lateral approach. SEQ subjective rating showed the same tendency.
Conclusions
Objective and subjective rating following TKA in the osteoarthritic fixed valgus knee appear to give more favourable results with the lateral approach. There were no postoperative complications related to the osteotomy of the tibial spine. Since the main pathology in the osteoarthritic fixed valgus knee is on the lateral side, it would be appropriate to use a lateral approach with easier application of all the different techniques of ligament release.