A Technique for Minimally Invasive, Quadriceps-Sparing Total Knee Arthroplasty

Berger, Richard A.; Deirmengian, Carl; Valle, Craig J. Della; Paprosky, Wayne G.; Jacobs, Joshua J.; Rosenberg, Aaron G.

doi:10.1055/s-0030-1248081

Cited by 19 publications

(5 citation statements)

References 12 publications

(7 reference statements)

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“…In contrast, Lombardini and colleagues [15] and Schroer and colleagues [20] found earlier hospital discharge with the minimally invasive subvastus approach. The application of rapid recovery protocols may accelerate the recovery of these patients and reduce the hospital stay [2,5,19]. However, one should not forget that Healy and colleagues [10] showed how an aggressive rapid recovery protocol was capable of reducing hospital stay and cost of TKA performed by the conventional approach as well.…”

Section: Resultsmentioning

confidence: 99%

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Minimally Invasive Subvastus Approach: Improving the Results of Total Knee Arthroplasty: A Prospective, Randomized Trial

Varela-Egocheaga

Suárez-Suárez

Fernández-Villán

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Minimally invasive knee arthroplasty seeks to diminish the problems of traditional extensile exposures aiming for more rapid rehabilitation of patients after surgery. Questions/purposesTo determine if the subvastus approach results in less perioperative pain and blood loss, shorter hospital stay, and improved function at both early and long-term followup.Methods One hundred patients were enrolled in a prospective, randomized trial. Fifty were operated on using a minimally invasive subvastus approach and the other 50 by a conventional, peripatellar approach. Minimum followup was 3 years. A repeated-measures analysis of variance was used to compare the Knee Society score and range of motion during followup. ResultsThe minimally invasive approach resulted in greater perioperative bleeding but no increase in transfusions. No differences were found in postoperative pain between groups nor did hospital stay show any differences.

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Section: Resultsmentioning

confidence: 99%

“…Some consensus exists regarding the surgical modifications that are required to provide a minimally invasive TKA [1,2,7,13,22,23]. The skin incision should be reduced (8-13 cm).…”

Section: Introductionmentioning

confidence: 99%

Minimally Invasive Subvastus Approach: Improving the Results of Total Knee Arthroplasty: A Prospective, Randomized Trial

Varela-Egocheaga

Suárez-Suárez

Fernández-Villán

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…The surgical technique for all patients consisted of a small incision technique that avoided disruption of the quadriceps tendon or vastus medialis obliquus muscle [1]. In all cases, patellar eversion, knee dislocation, and knee hyperflexion were avoided.…”

Section: Methodsmentioning

confidence: 99%

“…An immediate postoperative protocol was also consistently applied to all patients in the recovery room that included a second dose of 4 mg Zofran 1 combined with aggressive intravenous hydration therapy to prevent hypotension and nausea [1,3]. Epidural analgesia (10 lg/ mL fentanyl + 0.1% bupivacaine) at 6 mL, 1 mL every 15 minutes with a 40-mL 4-hour lockout, was continued.…”

Section: Methodsmentioning

confidence: 99%

The Feasibility and Perioperative Complications of Outpatient Knee Arthroplasty

Berger

Kusuma

Sanders

et al. 2009

Clin Orthop Relat Res

250

176

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The duration of hospitalization and subsequent length of recovery after elective knee arthroplasty have decreased. We hypothesized same-day discharge following either a unicompartmental (UKA) or total knee arthroplasty (TKA) in an unselected group of patients would not result in a higher perioperative complication rate than standardlength hospitalization when following a comprehensive perioperative clinical pathway, including preoperative teaching, regional anesthesia, preemptive oral analgesia, preemptive antiemetics, and a rapid rehabilitation protocol. We prospectively followed 111 of all 121 patients who had primary knee arthroplasty completed by noon and who agreed to be followed prospectively; 25 had UKA and 86 TKA. Of the 111 patients, 104 (94%, 24 with UKA and 80 with TKA) met discharge criteria and were discharged directly to home the day of surgery. Nausea requiring additional treatment before discharge was the most common reason for a delay in discharge. There were four (3.6%) readmissions (all with TKA) and one emergency room visit without readmission (in a patient with a TKA) within the first week after surgery, while there were four subsequent readmissions (3.6%) and one additional emergency room visit without readmission within three months of surgery, all among patients undergoing TKA. There were no deaths, cardiac events, or pulmonary complications during this study. Outpatient knee arthroplasty surgery is feasible in a large percentage of patients yet early readmissions may be decreased with a prolonged hospitalization.

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“…Inzwischen ist dieses Verfahren in gemischten Populationen in großer Zahl dokumentiert und wird in Zentren in den USA, Kanada und Australien regelmä-ßig durchgeführt [6,7,47]. Grundlage des Eingriffs ist eine modifizierte Operationstechnik mit einer kurzen Inzision, bei der die Quadrizepssehne geschont wird.…”

Section: Erweiterung Des Operativen Spektrumsunclassified

Zukunftsorientierte Gestaltung des ambulanten Operierens

Möllmann

2011

Anaesthesist

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Ambulatory surgery continues to grow and is slowly becoming routine in the majority of cases. Although the development of ambulatory surgery in Germany appears to be somewhat delayed, this is actually a chance to learn from worldwide experiences and avoid the mistakes others made earlier. This article investigates current trends and developments in day case surgery and discusses the extended role and influence of the anesthetist in the perioperative setting.

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A Technique for Minimally Invasive, Quadriceps-Sparing Total Knee Arthroplasty

Cited by 19 publications

References 12 publications

Minimally Invasive Subvastus Approach: Improving the Results of Total Knee Arthroplasty: A Prospective, Randomized Trial

Minimally Invasive Subvastus Approach: Improving the Results of Total Knee Arthroplasty: A Prospective, Randomized Trial

The Feasibility and Perioperative Complications of Outpatient Knee Arthroplasty

Zukunftsorientierte Gestaltung des ambulanten Operierens

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