Comparison of the Vastus-Splitting and Median Parapatellar Approaches for Primary Total Knee Arthroplasty: A Prospective, Randomized Study

Kelly, Matthew; Rumi, Mustasim N.; Kothari, Milind J.; Parentis, Michael A.; Bailey, Katrina J.; Parrish, William M.; Pellegrini, Vincent D.

doi:10.2106/jbjs.f.01190

Cited by 10 publications

(11 citation statements)

References 3 publications

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“…Blood loss was significantly lower in the MIS Group, both in terms of hemoglobin grams and in the amount of drained blood but the difference in the number of drains in each group could produce a bias in the results of our study. However these data are also in keeping with other studies [8,10] and are supposedly related to the less aggressive surgery. In any case, none of our patients needed to get a blood transfusion.…”

Section: Discussionsupporting

confidence: 92%

“…Few studies exist which have compared prospectively two groups of patients [8-14], one with MIS, one with the standard technique (Table 4) and, to our knowledge, no study has been published which has prospectively assessed patient-perceived outcomes after MIS-TKA and compared them with standard TKA. Thus, our study offers an original methodology: it compares both groups via functional scales, subjective impressions and opinions on quality of life, which is important to assess a technique proposed to enhance patient's satisfaction and cosmetic benefits.…”

Section: Discussionmentioning

confidence: 99%

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Total knee arthroplasties performed with a mini-incision or a standard incision. Similar results at six months follow-up

Hernández-Vaquero

Noriega-Fernandez

Suárez-Vázquez

2010

BMC Musculoskelet Disord

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BackgroundMinimal invasion surgery (MIS) is a recent technique recommended for Total knee arthroplasty (TKA) but demands an effort of the surgeons and the learning curve may be long.MethodsTwenty six MIS-TKA were matched to 36 standard TKA with respect to age, sex, body mass index or preoperative score. All patients suffered from knee osteoarthritis, which had not improved with medical treatment and which presented a less than 10° deformity in the coronal and sagittal radiographic projections. At six months after the surgery a specific questionnaire was completed as well as the KSS (Knee Society rating scale), the generic short-form health questionnaire (SF-12) and a visual analogue scale (VAS).ResultsThe MIS technique required more time of surgery (p < 0.001), hospital stay was noticeably shorter (p < 0.05) and drainage volume collected after surgery was significantly higher in the standard technique. We observe a higher frequency in small sizes implants for MIS surgery but no statistically significant differences were found between both groups regarding the radiological alignment of the implant. At six months no differences were found between the groups in range of motion, KSS scores, the physical or mental subscale SF-12, patient's pain perception, satisfaction or subjective improvement.ConclusionsMinimal invasion surgery in total knee arthroplasty showed no improvement over a standard approach.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Total knee arthroplasties performed with a mini-incision or a standard incision. Similar results at six months follow-up

Hernández-Vaquero

Noriega-Fernandez

Suárez-Vázquez

2010

BMC Musculoskelet Disord

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“…Dalury and colleagues 23,24 found that the MV approach does not lead to damage of the vastus medialis obliquus. Kelly et al 25 suggested that the vastus-splitting approach can preserve function of the extensor mechanism and reduce the need for lateral release. Bridgman et al 26 considered SV to be significantly superior to MP, in terms of the preservation of short-and long-term knee function.…”

Section: Days To Slrmentioning

confidence: 99%

Comparison of the Minimally Invasive and Standard Medial Parapatellar Approaches for Total Knee Arthroplasty: Systematic Review and Meta-Analysis

Liu

Yang

2011

J Int Med Res

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“…The patella was replaced in all cases and, on postoperative tangential radiographies, maintained its central position in 91% of the cases. Kelly et al [25] reported that LRR was required in one (4.5%) of 22 cases with the midvastus approach, and in 13 (45%) of 29 cases with the medial parapatellar approach. However, they detected abnormal EMG changes six months postoperatively in nine cases in the midvastus group, of which seven cases had normal, and two cases had subclinical EMG findings at the end of a five-year followup.…”

Section: Discussionmentioning

confidence: 99%

A Prospective Study of Total Knee Replacement with Minimally Invasive Mid Vastus Approach Showing Early Results

Nagpal

Goyal

2020

OPROJ

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The aim of this studythe early results of total knee arthroplasty (TKA)through minimally invasivemidvastus approach.Methods: This prospective study included 100 knee joints (43 females, 57 males; mean age61.3years) whounder went total knee arthroplasty forgrade 4 knee osteoarthritis.AllTKA operations were performed by the single orthopaedic surgeon through the minimally invasive midvastusapproach.Pre-operatively, all patients had primary osteoarthritis.In all cases,aPScemented prosthesis with modular insertwasused.All the knees were assessed according to theKneeSociety kneeand functions cores before surgery and atthefinal follow-up.Postoperative radiographic evaluations were performed on AP and lateral radiographs according to the knee society scoreevaluation and scoring system. The mean follow-up period was 6 months (range 3 to 12months). Results:The mean KSS score significantly improved from27.8±11.0 preoperatively to 92.2±3.8 post-operatively(p=0.000).The improvement in the knee functions core was from 54.223±23.43 to 94.07±7.720(p=0.000).The mean improvement in the KSS clinical and functions cores were 64.4 and39. 8points, respectively. The mean knee ROM significantly increased from 56.2±22.7°pre-operatively to 111.0±9.9°postoperatively (p=0.000). Patients had nopatellar trackingabnormalityintraoperatively;thus,there was none ed for lateral retinacular release.Postoperative clinical and radio graphicassessments showed no signs of instability or loosing. There were no changes in tracking and loosing of the implant during the follow up period. Neurovascular injury did not occur. Conclusion:In our study,lateral retinacular release was not doneduetoachievement of proper patellar tracking in TKA with minimally invasive midvastus approach and showing satisfactory clinical and radiographic results

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Comparison of the Vastus-Splitting and Median Parapatellar Approaches for Primary Total Knee Arthroplasty: A Prospective, Randomized Study

Cited by 10 publications

References 3 publications

Total knee arthroplasties performed with a mini-incision or a standard incision. Similar results at six months follow-up

Total knee arthroplasties performed with a mini-incision or a standard incision. Similar results at six months follow-up

Comparison of the Minimally Invasive and Standard Medial Parapatellar Approaches for Total Knee Arthroplasty: Systematic Review and Meta-Analysis

A Prospective Study of Total Knee Replacement with Minimally Invasive Mid Vastus Approach Showing Early Results

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