Medial vs Lateral Approach for Total Knee Replacement on Valgus Knee: a Randomized Clinical Trial (ValgusKnee)

University of Sao Paulo General Hospital

Status: Unknown

Conditions: Osteoarthritis

Treatments: Procedure: Keblish approach; Procedure: Medial approach

Study type: Interventional

Funder types: Other

Identifiers

NCT01965886

VALGUSKNEE

Details and patient eligibility

About

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.

Full 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.

Enrollment: 126 estimated patients

Sex: All

Volunteers: No Healthy Volunteers

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

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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126 participants in 2 patient groups

Medial approach

Active Comparator group

Description:

Medial parapatellar approach (classic approach)

Treatment:

Procedure: Medial approach

Keblish approach

Experimental group

Description:

Lateral parapatellar approach (Keblish approach)

Treatment:

Procedure: Keblish approach