A Randomized Prospective Study Evaluating the Effect of Patellar Eversion on the Early Functional Outcomes in Primary Total Knee Arthroplasty

A prospective, randomized, blinded study was designed to investigate the impact of patellar eversion on early quadriceps function after total knee arthroplasty. One hundred twenty-two consecutive patients were randomized by 2 surgeons to receive one of 2 different surgical approaches. Surgeon A randomized patients to receive a mid-vastus split with or without patellar eversion. Surgeon B randomized patients to receive a median parapatellar arthrotomy or a mid-vastus split, both without patellar eversion. For surgeon A, a significantly earlier return of straight leg raise was noted when patellar eversion was avoided. Significant correlation existed between an earlier return of straight leg raise and decreased length of stay. Avoiding patellar eversion enhanced the return of quadriceps function and led to a decreased length of stay in the hospital.