Aspirantskiy Vestnik PovolzhiyaAspirantskiy Vestnik PovolzhiyaАспирантский вестник Поволжья2072-23542410-3764Samara State Medical University70393610.35693/AVP703936TRAUMATOLOGY AND ORTHOPEDICSТРАВМАТОЛОГИЯ И ОРТОПЕДИЯReview ArticleComparative characteristics of the main approaches used in total knee arthroplastyСравнительная характеристика основных доступов, применяемых при тотальном эндопротезировании коленного суставаhttps://orcid.org/0009-0005-4112-4290Al-MamooriAhmedАль-МамуриАхмед
Russian Federation

MD, traumatologist, postgraduate student of the Department of Traumatology and Orthopedics

врач-травматолог, аспирант кафедры травматологии и ортопедии

ahmedalmamoori30@gmail.comhttps://orcid.org/0009-0008-3686-3138MahaniYahya S.МаханиЯхья Салехович
Russian Federation

MD, traumatologist, postgraduate student of the Department of Traumatology and Orthopedics

врач-травматолог, аспирант кафедры травматологии и ортопедии

ymahani@mail.ruhttps://orcid.org/0009-0005-4463-9134RedkoIgor A.РедькоИгорь Александрович
Russian Federation

MD, Dr. Sci. (Medicine), Professor of the Department of Traumatology and Orthopedics; Head of the Department of Traumatology and Orthopedics

д-р мед. наук, профессор кафедры травматологии и ортопедии; заведующий отделением травматологии и ортопедии

redkoi@list.ruhttps://orcid.org/0000-0002-5887-6545DombaanaiBaiyr S.ДомбаанайБайыр Сергеевич
Russian Federation

MD, PhD (Medicine), Analyst of the Department of Scientific Foundations of Healthcare Organization

канд. мед. наук, аналитик отдела научных основ организации здравоохранения

dombaanay@mail.ruPeoples’ Friendship University of RussiaФГАОУ ВО «Российский университет дружбы народов имени Патриса Лумумбы»Clinical Hospital No. 1 (Volynskaya) of the Property Management Department of the President of the Russian FederationФГБУ «Клиническая больница №١» (Волынская) Управления делами Президента РФResearch Institute for Healthcare Organization and Medical Management of the Moscow City Health DepartmentГБУ «Научно-исследовательский институт организации здравоохранения и медицинского менеджмента департамента здравоохранения города Москвы»060820261309202626339470803202629072026Copyright ©; 2026, Al-Mamoori A., Mahani Y.S., Redko I.A., Dombaanai B.S.Copyright ©; 2026, Аль-Мамури А., Махани Я.С., Редько И.А., Домбаанай Б.С.2026Al-Mamoori A., Mahani Y.S., Redko I.A., Dombaanai B.S.Аль-Мамури А., Махани Я.С., Редько И.А., Домбаанай Б.С.https://creativecommons.org/licenses/by/4.0https://aspvestnik.ru/2410-3764/article/view/703936

The choice of surgical approach for total knee arthroplasty remains a matter of debate. This review compares five main approaches: medial parapatellar, subvastus, midvastus, lateral parapatellar and quadriceps-sparing. These approaches are analyzed for their technical characteristics, perioperative parameters, and functional outcomes. Quadriceps-sparing approaches demonstrate advantages in the early postoperative period and are compatible with ERAS protocols. However, long-term functional outcomes are comparable across all approaches. The choice of the optimal surgical approach should be determined by individual patient characteristics, the degree of deformity, and the surgical experience of the operating team.

Выбор хирургического доступа при тотальном эндопротезировании коленного сустава остается предметом дискуссии. В настоящем обзоре проведен сравнительный анализ пяти основных доступов: медиального парапателлярного, субвастусного, мидвастусного, латерального парапателлярного и квадрицепс сберегающего по техническим характеристикам, периоперационным показателям и функциональным исходам. Квадрицепс сберегающие доступы показывают преимущества в раннем послеоперационном периоде и совместимы с ERAS-протоколами, однако в отдаленные сроки функциональные результаты сопоставимы при всех доступах. Выбор оптимального хирургического доступа должен определяться индивидуальными характеристиками пациента, степенью деформации и хирургическим опытом оперирующей команды.

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