A Modified Surgical Approach in Total Knee Arthroplasty – Reproducible in Primary and Revision Arthroplasty – Transtendinous of the Extensor Mechanism

Since 2017, we modified the traditional medial approach in TKA. We have used this modified method on 706 TKA patients, including 302 females and 281 males. We compared the results with other studies regarding the patellar complications in total knee arthroplasty. The difference between the two surgical methods essentially concerns the patellar complications in TKA. Patients using the medial modified approach have not experienced any avascular necrosis, stress fractures, or patellar dislocation or subluxation. Eighty of those 706 TKA cases had severe deformities, such as large preexisting defects, osteoporotic bone structure, or severe varus-valgus deviation. The same type of implants was used with or without tibial stem extension. This modified approach is reproducible, gives a large exposure, and allows revisions through the same approach. It is useful even in severe knee deformity, allowing tibial stem extension. The recovery is good due to the tendinous healing.