{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T01:36:38Z","timestamp":1787621798851,"version":"build-2736575974"},"reference-count":23,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,8,17]],"date-time":"2021-08-17T00:00:00Z","timestamp":1629158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The most common incision for total knee arthroplasty is the anterior midline incision; however, it is commonly associated with lateral knee numbness, kneeling difficulties and restricted flexion range. We sought to review the literature regarding the neurovascular supply and angiosomes over the anterior knee, and evaluate the anterolateral incision as a viable alternative for knee arthroplasty.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review of the literature was performed searching PUBMED, MEDLINE and EMBASE to evaluate the incisions available for total knee arthroplasty with respect to neurological function, kneeling ability and complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ten studies were identified evaluating midline or anterolateral incisions for total knee arthroplasty, with a total of 664 knees for analysis. Mean patient age was 68\u2009years (45\u201388), and average length of followup was 1\u00a0year. A total of 586 had an anterior midline incision and 78 had an anterolateral incision. A total of 62% of anterior midline incisions sustained altered sensation compared to 15% (12\/78) of anterolateral incisions (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). Incision length was similar in both groups (19.8\u00a0cm midline vs. 20.8\u2009cm anterolateral). Wound dehiscence was not significantly different between the two groups being 8.3% for midline incisions, and 2.5% for anterolateral incisions (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.153). Kneeling ability was reported in two studies which reported an improved ability to kneel with an anterolateral incision.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The lateral parapatellar incision respects the neurovascular anatomy of the knee and offers a significant reduction in sensory changes, better kneeling ability and similar rates of wound problems to a standard midline incision and should be considered as a viable alternative for knee arthroplasty.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.17136","type":"journal-article","created":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T03:58:26Z","timestamp":1629259106000},"page":"2167-2173","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Midline versus anterolateral incisions for total knee arthroplasty\u2014a systematic review and analysis of the angiosomes of the knee"],"prefix":"10.1111","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8479-5589","authenticated-orcid":false,"given":"David","family":"Slattery","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Victorian Bone and Joint Specialists  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Langston","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Melbourne Orthopaedic Group  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Shumack","sequence":"additional","affiliation":[{"name":"Department of Statistics Federation University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Melbourne Orthopaedic Group  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,17]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2013.05.011"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-009-1119-9"},{"key":"e_1_2_8_4_1","first-page":"863","article-title":"Dermal hypoesthesia after total knee arthroplasty","volume":"29","author":"Johnson DF","year":"2000","journal-title":"Am J Orthop"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199910000-00024"},{"key":"e_1_2_8_6_1","first-page":"649","article-title":"Cutaneous sensory loss following primary total knee arthroplasty. 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