Keblish describes a direct lateral parapatellar approach for TKA in patients with fixed valgus deformity, detailing step-by-step surgical technique and reporting outcomes in 53 knees (from 79 total) with minimum two-year follow-up. The central question: does a lateral approach better address the pathologic anatomy of valgus deformity than the standard medial approach?
When planning TKA for a patient with fixed valgus deformity — especially a rheumatoid or elderly woman with deformity >15°–20° — consider the lateral approach: it incorporates the lateral release into the exposure, preserves medial patellar blood supply, and eliminates the patellofemoral maltracking problems that plague the medial approach in this anatomy.
The trade-off is a steeper learning curve and longer operative time, but the technique provides more predictable soft-tissue balance and avoids the need for constrained implants.
Keblish describes a direct lateral parapatellar approach for TKA in patients with fixed valgus deformity, detailing step-by-step surgical technique and reporting outcomes in 53 knees (from 79 total) with minimum two-year follow-up. The central question: does a lateral approach better address the pathologic anatomy of valgus deformity than the standard medial approach?
When planning TKA for a patient with fixed valgus deformity — especially a rheumatoid or elderly woman with deformity >15°–20° — consider the lateral approach: it incorporates the lateral release into the exposure, preserves medial patellar blood supply, and eliminates the patellofemoral maltracking problems that plague the medial approach in this anatomy.
The trade-off is a steeper learning curve and longer operative time, but the technique provides more predictable soft-tissue balance and avoids the need for constrained implants.