Differences in the Clinical Outcome of Total Knee Arthroplasty Based on Skin Incision, Approach, and Use of Lateral Release

The type of skin incision (medial parapatellar versus straight midline) made no difference to the incidence of skin necrosis in 309 knee joints operated on at the Department of Orthopedic Surgery of Nagoya City University Medical School between 1972 and 1996. Comparison of the postoperative knee flexion angle and range of motion (ROM) in 245 knee joints operated on using the medial parapatellar approach or the midvastus approach showed that both parameters were significantly better when the midvastus approach was used. Performance of lateral release had no effect on the postoperative knee flexion angle or ROM. However, patellar necrosis occurred in 2 joints out of 146 joints operated on using lateral release combined with the medial parapatellar approach.