Engh G A, Parks N L
Anderson Orthopaedic Research Institute, Alexandria, VA 22307, USA.
Clin Orthop Relat Res. 1998 Jun(351):270-4. doi: 10.1097/00003086-199806000-00032.
For more than 25 years most surgeons have used a medial parapatellar surgical approach for total knee arthroplasty because this technique affords simplicity and excellent exposure to all compartments of the knee. This article describes how the midvastus muscle splitting approach achieves surgical exposure equivalent to that of the standard medial parapatellar approach, while preserving the integrity of the vastus medialis insertion into the medial border of the quadriceps tendon. This total knee arthroplasty approach divides the vastus medialis muscle in the direction of its fibers, as opposed to the traditional method of splitting the quadriceps tendon above the patella. The limited disruption of the extensor mechanism improves the rapid restoration of quadriceps muscle control. In addition, a more stable patellofemoral articulation is evidenced by a marked reduction in the need for lateral retinacular releases.
25 多年来，大多数外科医生在全膝关节置换术中采用髌旁内侧手术入路，因为该技术操作简单，能很好地显露膝关节的各个腔室。本文描述了股中间肌劈开入路如何在保留股内侧肌附着于股四头肌腱内侧缘完整性的同时，实现与标准髌旁内侧入路相当的手术显露。这种全膝关节置换入路是沿股内侧肌纤维方向进行劈开，与传统在髌骨上方劈开股四头肌腱的方法不同。伸肌机制的有限破坏有助于股四头肌控制的快速恢复。此外，外侧支持带松解需求的显著减少证明髌股关节的稳定性更高。
