Lateral approach with osteotomy of the tibial tubercle in primary total knee arthroplasty

In a prospective study of 51 patients (61 cases) with primary total knee ar throplasty (valgus knees and/or knees that had undergone previous nonarthro plasty surgery), a lateral approach with osteotomy of the tibial tubercle w as performed. In a lateral approach, lateral release techniques form part o f the approach. In addition, the medial blood supply to the patella is pres erved. An additional tibial osteotomy grants wide exposure with little tens ion on the extensor mechanism during eversion of the patella. The patients mere followed up clinically (51 patients, 61 cases) and radiologically (44 patients, 52 cases) for 1 year. No postoperative tibial fractures, no delay ed unions, and no nonunions at the site of the osteotomy were seen. No pate llar necrosis occurred. The results after 1 year were good or excellent in 45 (88%) patients, fair in four (8%), and poor in two (4%). Complications r elated to technique were hematoma (four patients) and compartment syndrome (one patient). These complications occurred early in the series and were el iminated by technical modifications.