Research Article Open Access
Volume 2 | Issue 1 | DOI: https://doi.org/10.33696/Orthopaedics.2.023

Evaluation of Patellofemoral Complications by Comparing the Medial Parapatellar and Subvastus Approaches

  • 1Mustafa Kemal University Faculty of Medicine, Department of Orthopaedics and Traumatology, Antakya, Hatay, Turkey
  • 2Mustafa Kemal University Faculty of Medicine Department of Biostatistics, Antakya, Hatay, Turkey
+ Affiliations - Affiliations

Corresponding Author

Mehmet Menken, mehmetmenken@hotmail.com

Received Date: July 08, 2021

Accepted Date: August 19, 2021


Introduction and Aim: The aim of this study was to investigate the relationship of the medial parapatellar (MPP) approach and the subvastus (SV) approach, which are frequently used in total knee arthroplasty, with patellofemoral complications and to compare patient satisfaction.

Material and Methods: In this study, we evaluated 488 patients who presented to our hospital between 2010 and 2020, were diagnosed with osteoarthritis, underwent total knee arthroplasty, and were followed up. The surgery was performed using the MPP approach in 242 of these patients (49.6%) and the SV approach in 246 (50.4%). The mean follow-up duration was 52 months for the MPP group (range 14-83 months) and 50 months (range 15-79 months) for the SV group. We compared these two patient groups in terms of anterior knee pain, patellar tilt, lateral retinacular release requirement, patella baja, and the WOMAC score.

Results: When the MPP and SV groups were compared in terms of the patients’ demographic characteristics, no significant difference was found in age (p=0.186), gender (p=0.769), and body mass index (p=0.051). The incidences of lateral retinacular release requirement (p=0.001) and patellar tilt (p=0.001) were significantly lower in the SV approach than in the MPP approach. However, there was no significant difference between the two groups in terms of anterior knee pain (p=0.087), patella baja (p=0.136), and WOMAC score (p=0.052). In addition, it was observed that lateral retinacular release increased the incidence of patellar tilt (p=0.001) but did not affect the incidence of anterior knee pain (p=0.946) and the patella baja (p=0.523).

Conclusion: The SV approach is advantageous over the MPP approach in reducing patellofemoral complications. However, despite these advantages, no significant difference was found between the two approaches in relation to the WOMAC scores of the patients. Therefore, although the SV approach decreased patellofemoral complications, it may have increased other complications associated with total knee arthroplasty.


Medial parapatellar, Subvastus, Patellofemoral, Complications, Total knee arthroplasty

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