[Anterolateral Approach of TKA.]

Area of Science:

• Orthopedic Surgery
• Biomechanics
• Surgical Approaches

Context:

• Total knee arthroplasty (TKA) is a common procedure for severe knee joint deformities.
• Valgus knee deformities present unique surgical challenges, particularly regarding patellar tracking and implant stability.
• Traditional anteromedial approaches may compromise patellar vascularity and necessitate extensive lateral release in valgus knees.

Purpose:

• To describe and evaluate the anterolateral surgical approach for total knee arthroplasty in severe valgus knee deformities.
• To compare the anterolateral approach with the conventional anteromedial approach.
• To assess the functional outcomes and complications associated with the anterolateral approach in this patient population.

Summary:

• The anterolateral approach for TKA in valgus knees involves releasing the lateral retinaculum, allowing for improved patellar mobility and balanced joint alignment.
• This technique preserves patellar blood supply better than the medial approach, potentially reducing the risk of avascular necrosis.
• A modified technique of tibial tuberosity "feathering" addresses the challenge of patellar dislocation for bone resection without requiring fixation.

Impact:

• The anterolateral approach provides a physiological and effective surgical option for TKA in severe valgus knees.
• It demonstrates favorable outcomes, including good range of motion and reduced risk of patellar complications.
• This approach may offer advantages in restoring normal patellar kinematics and improving overall joint function post-TKA.