Clinical Comparison of the Midvastus and Medial Parapatellar Surgical Approaches

Patellar Tracking and Anterior Knee Pain are Similar After Medial Parapatellar and Midvastus Approaches in Minimally Invasive TKA

“…The changes in patellar tracking with time with the MPP approach are an important concern for many orthopaedic surgeons [15,20,22,26]. As a result, they use the MV approach instead of the MPP approach in conventional TKAs [8,9,17,31]. The extensor mechanism suffers less damage and the patella is not everted in a MIS TKA, which would result in good patellar tracking and lower incidence of anterior knee pain.…”

“…last decade, has some potential advantages regarding patellar tracking and lateral retinacular release rate [8,9,17,31]. Therefore, some orthopaedic surgeons use the MV approach rather than the MPP approach to reduce patellar maltracking.…”

RETRACTED: Surgical approaches for total knee arthroplasty

“…17 Parentis et al 18 noted electromyographic abnormalities in vastus medialis in patients undergoing the midvastus approach in 43% of cases compared with none in the medial parapatellar group. Keating et al 19 in a randomized prospective trial reported no differences in range of motion, straight leg raise, and requirement for lateral releases in a series of 100 patients. The authors did not recommend the approach as being superior to the medial parapatellar approach.…”

“…Less blood loss 18 and fewer intraoperative lateral releases have been reported. [17][18][19] There have been equivocal opinions regarding the use of midvastus approach in patients with difficult access. 19,20 Advocates of this approach believe that it is easier to evert the patella with the midvastus approach than with the subvastus approach because of the reduced bulk of the vastus medialis.…”

Less invasive approach in knee arthroplasty: everybody on board?

“…Besides that, full-length coronal radiography did not show more outliers in midvastus group compared with control. Better patellar tracking is expected in midvastus approach, reflected by low rate of lateral retinacular release needed (6)(7)(8)(9). This might be explained by the vastus medialis connections left intact together with quadriceps tendon, resulting in better patellar excursion.…”