Comparing the mid-vastus and medial parapatellar approaches in total knee arthroplasty: A meta-analysis of short term outcomes

Alcelik, Ilhan; Sukeik, Mohamed; Pollock, Raymond; Misra, Anand; Naguib, Ashraf M.; Haddad, Fares S.

doi:10.1016/j.knee.2011.07.010

Cited by 27 publications

(25 citation statements)

References 26 publications

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“…There were no differences in lateral retinacular release, blood loss, straight leg raise, hospital stay and postoperative complications. These results were mostly in accordance well with the previous meta-analysis [31]. In that meta-analysis, the authors found that the midvastus group significantly decreased lateral release rate compared with the standard group, while our result did not find different between two groups.…”

Section: Discussionsupporting

confidence: 93%

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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: 93%

“…An earlier meta-analysis [31] had compared the short-term results of the midvastus with the standard approach. Their results showed that the midvastus approach obtained better postoperative recovery, less lateral release and complication rates than the standard approach.…”

Section: Discussionmentioning

confidence: 99%

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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“…This is the most popular approach to the knee in TKA. It provides excellent exposure of the knee joint, but violates the extensor mechanism and blood supply to the patella, which can affect early rehabilitation [62-64]. …”

Section: Surgical Interventionsmentioning

confidence: 99%

“…described the midvastus approach in 1997. It involves opening an interval into the midsubstance of the vastus medialis while preserving its attachment to the quadriceps tendon in order to preserve function [62,65]. The advantages of this approach include increased patellofemoral stability, increased postoperative quadriceps control, and decreased scarring in the quadriceps tendon.…”

Section: Surgical Interventionsmentioning

confidence: 99%

Peri-operative interventions producing better functional outcomes and enhanced recovery following total hip and knee arthroplasty: an evidence-based review

Ibrahim

Khan

Nizam

et al. 2013

BMC Med

169

117

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The increasing numbers of patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA), combined with the rapidly growing repertoire of surgical techniques and interventions available have put considerable pressure on surgeons and other healthcare professionals to produce excellent results with early functional recovery and short hospital stays. The current economic climate and the restricted healthcare budgets further necessitate brief hospitalization while minimizing costs.Clinical pathways and protocols introduced to achieve these goals include a variety of peri-operative interventions to fulfill patient expectations and achieve the desired outcomes.In this review, we present an evidence-based summary of common interventions available to achieve enhanced recovery, reduce hospital stay, and improve functional outcomes following THA and TKA. It covers pre-operative patient education and nutrition, pre-emptive analgesia, neuromuscular electrical stimulation, pulsed electromagnetic fields, peri-operative rehabilitation, modern wound dressings, standard surgical techniques, minimally invasive surgery, and fast-track arthroplasty units.

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“…However, critics of this approach have argued that incising the quadriceps tendon weakens quadriceps function. More recently, the midvastus approach has gained in popularity due to its advantages of less postoperative pain, preservation of the quadriceps tendon, and more rapid recovery of straight leg raise motion [19][20][21][22]. In the current study, the midvastus approach provided greater improvement of knee flexion than the parapatellar approach, which may have occurred for two reasons.…”

Section: Discussionmentioning

confidence: 65%

Quadriceps tendon pie-crusting release of stiff knees in total knee arthroplasty

Liu

Wen

2015

Journal of Orthopaedic Science

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Comparing the mid-vastus and medial parapatellar approaches in total knee arthroplasty: A meta-analysis of short term outcomes

Cited by 27 publications

References 26 publications

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

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

Peri-operative interventions producing better functional outcomes and enhanced recovery following total hip and knee arthroplasty: an evidence-based review

Quadriceps tendon pie-crusting release of stiff knees in total knee arthroplasty

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