{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T19:52:26Z","timestamp":1771962746885,"version":"3.50.1"},"reference-count":16,"publisher":"Bentham Science Publishers Ltd.","issue":"1","license":[{"start":{"date-parts":[[2015,5,15]],"date-time":"2015-05-15T00:00:00Z","timestamp":1431648000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":["openorthopaedicsjournal.com","benthamopen.com"],"crossmark-restriction":true},"short-container-title":["TOORTHJ"],"published-print":{"date-parts":[[2015,5,15]]},"abstract":"<jats:p>Constrained implants are frequently used for primary total knee arthroplasty (TKA) in patients with moderate and severe genu-valgum (&gt;10\u02da). This deformity presents corrective challenges for ligament release. The lateral-parapatellar approach has been advocated as an alternative to the traditional medial-parapatellar approach. Claimed advantages include better access for release of tight ligamentous structures, without requirement for release of the medial-collateral ligament.<\/jats:p><jats:p>We present our comparative experience of the use of an unconstrained knee-replacement prosthesis inserted by the lateral-parapatellar approach in comparison to a constrained-knee prosthesis inserted<jats:italic>via<\/jats:italic>the medial-parapatellar approach.<\/jats:p><jats:p>49 primary total knee-replacements in 48 (6 males, 42 females) patients were performed; 32 through a lateral-parapatellar approach (group L) using an unconstrained-prosthesis and 17 through a medial-parapatellar approach more often requiring a constrained-prosthesis (group M). Mean preoperative valgus angle was 18.5 (range 11-34\u02da). Patient demographics (p=0.7) and valgus correctability were similar between the two groups.<\/jats:p><jats:p>There was no significant difference in the mean post-operative valgus angle. This was 4.2\u02da (range 1-9.5\u02da) using the lateral-parapatellar approach and 5.3\u02da (range 0.3-10\u02da), p=0.12, using the medial-parapatellar approach.<\/jats:p><jats:p>Transient common peroneal injury occurred in 2 patients, both group L, in the presence of valgus angles of greater than 20\u02da. To date no joints have been revised, or are unstable.<\/jats:p><jats:p>The use of a lateral-parapatellar approach, appropriate soft tissue release, and an unconstrained PCL-preserving implant, yielded in all cases a stable, well aligned knee arthroplasty. This represents a viable alternative to the constrained-prosthesis using a medial-parapatellar approach in patients with moderate and severe genu-valgum.<\/jats:p>","DOI":"10.2174\/1874325001509010094","type":"journal-article","created":{"date-parts":[[2015,5,27]],"date-time":"2015-05-27T05:41:30Z","timestamp":1432705290000},"page":"94-97","update-policy":"https:\/\/doi.org\/10.2174\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Arthroplasty in the Valgus Knee: Comparison and Discussion of Lateral vs Medial Parapatellar Approaches and Implant Selection"],"prefix":"10.2174","volume":"9","author":[{"given":"Jai","family":"Rawal","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam J","family":"Devany","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James A","family":"Jeffery","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"965","reference":[{"key":"refR1","first-page":"260","volume":"95","author":"Girard J","year":"2009","unstructured":"Girard J, Amzallag M, Pasquier G , et al. 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