Osteoarthritis
Conditions
Keywords
osteoarthritis, knee, arthroplasty, replacement
Brief summary
The most common surgical approach to perform a total knee replacement is called medial parapatellar approach. It's effective and can be applied virtually to all types of knee deformities. The Keblish approach is an alternative approach which uses the lateral side of the patella to enter the joint. Some orthopaedic surgeons consider the latter approach a better option when facing a valgus deformity of the osteoarthritic knee but there is no convincing evidence on the literature supporting one or another approach. The objective of this study is to compare the medial vs lateral approach for total knee replacement on valgus knee.
Detailed description
Total knee replacement is a procedure for the treatment of advanced knee osteoarthritis. The most common surgical approach to perform a total knee replacement is called medial parapatellar approach, or simply medial approach. It's effective and can be applied virtually to all types of knee deformities. The Keblish approach is an alternative approach which uses the lateral side of the patella to enter the joint. It's also called lateral parapatellar approach. Some orthopaedic surgeons consider the latter approach a better option when facing a valgus deformity of the osteoarthritic knee. Theoretically, the Keblish approach can promote better soft tissue balance and patellar tracking, but there is no convincing evidence on the literature supporting one or another approach for a total knee replacement on valgus knee. The objective of this prospective and randomized clinical trial is to compare the medial vs lateral approach for total knee replacement on valgus knee.
Interventions
PROCEDUREMedial approach
Total knee replacement performed through a longitudinal incision medial to the patella
PROCEDUREKeblish approach
Total knee replacement performed through a longitudinal incision lateral to the patella
Sponsors
University of Campinas, Brazil
University of Sao Paulo General Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Severe osteoarthritis (Kellgren & Lawrence grade 4) * Valgus deformity of the knee * Read and sign the informed consent form
Exclusion criteria
* Severe pain in other joint (VAS\>6) * Comorbidities or any condition that contraindicate the procedure * Previous arthroplasty on the index knee
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Knee Score | 1 year | Evaluation of patient's pain and function using the Knee Society questionnaire |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| WOMAC | 2 years | Evaluation of patient's symptoms using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) |
| VAS | 2 years | Evaluation of patient's symptoms using the VAS (Visual Analogic Scale of pain) |
| Knee alignment | 6 months | Radiographic analysis of the knee alignment |
| Hemoglobin | 3 days | Analysis of patient's hemoglobin to estimate blood loss |
Countries
Brazil
Contacts
Primary ContactGustavo C Campos, MD
Outcome results
None listed