Langen Susanne, Gaber Sonja, Zdravkovic Vilijam, Giesinger Karlmeinrad, Jost Bernhard, Behrend Henrik
Department of Orthopaedic Surgery and Traumatology, Kantonsspital St. Gallen, 9007, St. Gall, Switzerland.
Eur J Orthop Surg Traumatol. 2016 Feb;26(2):215-22. doi: 10.1007/s00590-015-1718-y. Epub 2015 Nov 14.
The lateral subvastus approach (LSVA) with tibial tubercle osteotomy (TTO) is an alternative approach for total knee arthroplasty (TKA) in selected patients. The aim of this study was to compare clinical outcomes between LSV and medial parapatellar approaches for primary TKA and to investigate incidence of complications related to TTO.
A total of 580 patients with primary TKA, meeting the inclusion criteria, were treated at our hospital from February 2006 until February 2013. All patients' data were included in the local arthroplasty register and were followed up 12 months postoperatively. The data set contains: demographic data, the WOMAC score, the KSS as well as knee flexion and complications related to tibial tubercle osteotomy.
The clinical outcome after TKA using the LSVA combined with TTO was comparable with those using the medial standard approach 1 year postoperatively. Four patients (3.8 %) needed a revision due to complications related to tubercle osteotomy.
The LSVA is thus a viable alternative in cases of primary TKA if technical difficulties with the medial approach are anticipated. Applying precise surgical technique, the LSVA seems to be a safe and reproducible procedure.
带胫骨结节截骨术（TTO）的股外侧肌下入路（LSVA）是特定患者全膝关节置换术（TKA）的一种替代入路。本研究旨在比较初次TKA的LSV入路与髌旁内侧入路的临床结局，并调查与TTO相关的并发症发生率。
2006年2月至2013年2月期间，我院共治疗了580例符合纳入标准的初次TKA患者。所有患者的数据均纳入当地关节置换登记册，并在术后12个月进行随访。数据集包括：人口统计学数据、WOMAC评分、KSS评分以及膝关节屈曲度和与胫骨结节截骨术相关的并发症。
术后1年，采用LSVA联合TTO进行TKA的临床结局与采用内侧标准入路的相当。4例患者（3.8%）因与结节截骨术相关的并发症需要翻修。
因此，如果预计内侧入路存在技术困难，LSVA在初次TKA病例中是一种可行的替代方法。应用精确的手术技术，LSVA似乎是一种安全且可重复的手术。
