A prospective randomised study of minimally invasive midvastus total knee arthroplasty compared with standard total knee arthroplasty

Guy, Stephen; Farndon, Mark A.; Conroy, Jonathon L.; Bennett, Caroline; Grainger, Andrew J.; London, N. J. M.

doi:10.1016/j.knee.2012.04.009

Cited by 29 publications

(37 citation statements)

References 48 publications

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“…With regard to KSS, we did not observe any differences between the mini-midvastus and standard approach up to 1 year postoperatively. This corresponded well with the recent studies [5], [11]. Zhang et al [11] compared 45 midvastus TKAs with 44 parapatellar TKAs and found no significant difference in KSS during the follow-up period (7 days, 6 weeks, 3 months and 6 months).…”

Section: Discussionsupporting

confidence: 90%

“…The initial search found 307 potentially relevant citations from PubMed, EMBASE, Cochrane Library and Web of Science. After carefully screening the title, abstract and full text, 18 RCTs were finally included [5], [11]–[17], [21]–[30].…”

Section: Resultsmentioning

confidence: 99%

“…First, that study only analyzed the short-term outcomes without the analysis of the long-term results; second, the data of meta-analysis was based on not only RCTs but also quasi-RCTs, which might lower the strength of evidence; third, the studies which did not use MIS technique in midvastus approach was also included in meta-anlysis, which might effect the specificity of the mini-midvastus; fourth, the meta-analysis should be updated as a number of well-designed RCTs were recently published [5], [11]–[14], [21], [22]. Compared with the published meta-analysis, we included 7 more RCTs [5], [11]–[14], [21], [22] and excluded 4 RCTs [32]–[35] who did not use MIS in the midvastus group. Therefore, we believe our evidence was stronger on the efficiency of the mini-midvastus approach in TKA.…”

Section: Discussionmentioning

confidence: 99%

“…In MIS TKA, subvastus, midvastus and quads-sparing approaches are the most commonly alternatives to standard parapatellar approach [5], [6]. Subvastus and quads-sparing approaches preserved the knee extensor mechanism, and thus were regarded as more minimally invasive than the parapatrllar approach.…”

Section: Introductionmentioning

confidence: 99%

“…However, the conclusions among studies are still controversial. Some studies found no differences between mini-midvastus and parapatellar approaches [5], [11]–[13], whereas others supported the mini-midvastus [14], [15] or standard parapatellar approach [11], [16], [17]. Therefore, we designed this meta-analysis to quantitatively compare the clinical efficacy and safety of mini-midvastus and parapatellar approach in TKA.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Minimally Invasive Midvastus versus Standard Parapatellar Approach in Total Knee Arthroplasty: A Meta-Analysis of Randomized Controlled Trials

Lin

Xiang

et al. 2014

PLoS ONE

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ObjectiveMinimally invasive midvastus approach (mini-midvastus) has been widely used in total knee arthroplasty (TKA). However, the clinical effects still remains controversial. This meta-analysis was based on randomized controlled trials (RCTs) aiming to quantitatively analyze the clinical efficacy of mini-midvastus versus standard parapatellar approach in TKA.MethodsThis meta-analysis was performed according to the PRISMA guidelines. A literature search for the eligible RCTs was carried out in the databases of PubMed, the Cochrane library, EMBASE and Web of Science. Two independent reviewers independently completed the study selection, data extraction, and the assessment of methodological quality. Meta-analysis was conducted by the RevMan 5.2 software.ResultsA total of 18 RCTs (937 patients with 1093 TKAs) published from 2007 to 2013 were included. The meta-analysis suggested that the mini-midvastus approach significantly improved knee range of motion (ROM) and decreased visual analog score (VAS) at postoperative 1–2 weeks (p<0.05), and there were no statistical differences in terms of knee society score (KSS) (6 weeks to 1 year), VAS (6 weeks to 6 months), ROM (6 weeks to 6 months), lateral retinacular release, blood loss, straight leg raise, hospital stay and postoperative complications between the mini-midvastus and standard parapatellar approach (p>0.05). However, the operative time was significantly longer when performing the mini-midvastus group than the parapartellar approach (p<0.05).ConclusionThis meta-analysis found that compared with the standard parapatellar approach, the mini-midvastus approach had early advantages in the VAS and ROM, but had the disadvantage in the operative time.Level of EvidenceTherapeutic study Level I.

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Section: Discussionsupporting

confidence: 90%