Prophylactic Antipropagation Stitch in Total Knee Arthroplasty Performed via Medial Parapatellar Approach: A Simple and Cost-Effective Technique for Reducing Quadriceps Injury


This article describes a novel, simple, and effective technique for limiting extensor mechanism damage during total knee arthroplasty (TKA) performed via the medial parapatellar (MPP) approach. Immediately on making the quadriceps tendon split in the MPP approach, a figure-of-eight stitch is placed at the apex of the split. The prophylactic stitch technique has been used by one surgeon in 1000 consecutive TKAs over the past 5 years. This technique has eliminated proximal extension of the quadriceps tendon split into the muscle belly and may help to decrease postoperative pain, increase postoperative quadriceps strength, and improve patient satisfaction and outcomes. (Journal of Surgical Orthopaedic Advances 22(4):333–335, 2013)

Arjun Kanuri, BA; Sumon Nandi, MD; Addison Wilson, MD; and James V. Bono, MD