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The midvastus approach for total knee arthroplasty

  • Orthopedics And Traumatology
  • Published:
Orthopedics and Traumatology

Abstract

Objective

Approach to the knee for total knee arthroplasty with the goal to avoid tendency to lateralization and extension lag.

Indications

Implantation of total knee components.

Revision surgery after total knee arthroplasty.

Contraindications

Morbid obesity.

For revision surgery: preoperative knee flexion of <60°.

Surgical Technique

Anterior midline incision, blunt separation of the distal part of the obliquely running fibers of the vastus medialis over an extent of at least 5 cm. The muscle incision ends at the proximal and medial corner of the patella and is continued distally along the medial patellar border ending at the tibial tuberosity. After opening of the joint, the patella is dislocated laterally thus exposing the articular surfaces. After insertion of the components, superficial adaptation of the muscle fibers and wound closure in layers.

Results

Of 297 total knee implants 276 knees (92.9%) could be followed up for an average of 36.2 (19–56) months. 153 knees were in women and 123 in men with an average age of 66.3 (33–81) years. In none of the operations a lateral release became necessary. The results were based on the score of the American Knee Society. The score showed 52.3 points preoperatively and 90.6 at follow-up. 95% of the patients had an excellent or good functional result. Tangential radiographs of the patella with the knee in 30° of flexion showed in 91% a central position in the patellar groove.

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Authors and Affiliations

  1. Orthopedic Clinic and Policlinic, Martin Luther University Halle-Wittenberg, Magdeburger Straße 22, 06097, Halle/Saale, Germany

    Robert Hube & Heiko Reichel

  2. Department of Orthopedic Surgery, Allegheny General Hospital, Pittsburgh, PA, USA

    Nicholas G. Sotereanos

Authors
  1. Robert Hube
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  2. Nicholas G. Sotereanos
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  3. Heiko Reichel
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Correspondence to Heiko Reichel.

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Hube, R., Sotereanos, N.G. & Reichel, H. The midvastus approach for total knee arthroplasty. Orthop Traumatol 10, 235–244 (2002). https://doi.org/10.1007/s00065-002-1052-x

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  • DOI: https://doi.org/10.1007/s00065-002-1052-x

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