Early functional outcome after subvastus or parapatellar approach in knee arthroplasty is comparable

Hemert, Wouter L.W. van; Senden, Rachel; Grimm, Bernd; Linde, Matthijs J. A. van der; Lataster, Arno; Heyligers, Ide C.

doi:10.1007/s00167-010-1292-0

Cited by 28 publications

(56 citation statements)

References 40 publications

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“…However, in present study there was no statistically significant difference in blood loss in the two groups. Blood loss in the present study was much less in comparison to various other studies, 12,13 as shown in ►Table 6.…”

Section: Discussioncontrasting

confidence: 58%

Outcome of Total Knee Replacement via Two Approaches in Indian Scenario

et al. 2016

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This study was designed to assess the early and late clinical and functional outcome based on Knee Society Score in patients undergoing total knee replacement (TKR) by medial parapatellar approach/midvastus approach. A total of 52 patients were included in the study of whom 28 patients were operated by medial parapatellar approach and 24 by midvastus approach. Patients were assessed on the basis of Knee Society Score, along with other parameters such as duration of hospital stay, blood loss during, and after surgery. The patients were followed up at 2 weeks, 6 weeks, 3 months, 6 months, and 1 year. The knee objective score showed significant better scores in midvastus group at 2 weeks, 6 weeks, and 3 months, but the score in both the groups was not significant at 6 months and 1 year. The knee functional score showed significant better score in midvastus group at the end of 2 and 6 weeks. However, score in both the groups was not significant by the end of 3 months, 6 months, and 1 year. Patients' satisfaction and expectation scores were similar in both groups at all time intervals. The functional outcome of TKR surgery by midvastus approach was better in the first 3 months in comparison to medial parapatellar approach.

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Section: Discussioncontrasting

confidence: 58%

Outcome of Total Knee Replacement via Two Approaches in Indian Scenario

et al. 2016

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“…One study showed that quadriceps strength was significantly better in the subvastus group in the early postoperative period, but not during long-term follow-up after TKA [63]. Another study showed no differences in knee scores in the early postoperative period, except for slightly less extension lag in the subvastus group [67]. Patellar vascularity was not compromised nor was there any difference in anterior knee pain between the subvastus and medial parapatellar approaches [68].…”

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

170

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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“…Nine studies that met the inclusion criteria were included in the meta- analysis (Figure 1). 10,[14][15][16][19][20][21][22][23] Of the included trials, 8 were randomized controlled trials 10,14-16,19-22 and 1 was a quasirandomized, controlled trial (randomized by hospital number). 23 In addition, 2 quasirandomized, controlled trials (randomized by surgeon) were excluded 11,24 because the data were unavailable for meta-analysis.…”

Section: Description Of Studiesmentioning

confidence: 99%

“…10 Several trials have compared the clinical results of the subvastus and medial parapatellar approaches in TKA, but the conclusions were conflicting. Van Hemert et al 14 and Bourke et al 15 advised not to use the subvastus approach because no significant benefits were found. However, Roysam and Oakley 10 and Sastre et al 16 recommended using the subvastus approach for TKA due to its superior clinical and func-tional results.…”

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confidence: 99%

Subvastus Versus Medial Parapatellar Approach in Total Knee Arthroplasty: Meta-analysis

Teng¹,

Du²,

Jiang³

et al. 2012

Orthopedics

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The subvastus and medial parapatellar approaches are 2 commonly performed techniques in total knee arthroplasty, but the optimal approach for total knee arthroplasty remains controversial. The purpose of this study was to compare the effectiveness and safety of the subvastus vs medial parapatellar approach.The PubMed, Embase, Cochrane Library, Inter-Services Intelligence Web of Knowledge, and Chinese Biomedical Literature databases were searched for eligible quasi-randomized, controlled and randomized, controlled trials. Two authors independently extracted data and assessed the methodological quality of the included studies according to the Cochrane handbook version 5.1.0. Statistical analysis was performed using Review Manager version 5.1 software. Eight randomized, controlled trials and 1 quasi-randomized, controlled trial involving 940 primary total knee arthroplasties were included for meta-analysis. Meta-analysis revealed significant differences favoring the subvastus group in Knee Society Score in terms of function at 4 to 6 weeks (weighted mean difference [WMD]=5.09; 95% confidence interval [CI], 3.08 to 7.09; P<.01) and knee score at 12 months (WMD=2.17; 95% CI, 0.01 to 4.34; P=.05) and lateral retinacular release (odds ratio=0.34; 95% CI, 0.14 to 0.79; P=.01) when compared with the medial parapatellar approach. However, both groups showed similar results in range of motion (P>.05), operative time (WMD=2.15; 95% CI, -3.61 to 7.35; P=.42), blood loss (WMD= -31.07; 95% CI, -91.89 to 29.75; P=.32), hospital stay (WMD= -0.18; 95% CI, -0.67 to 0.31; P=.47), and postoperative complications (P>.05).

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Early functional outcome after subvastus or parapatellar approach in knee arthroplasty is comparable

Cited by 28 publications

References 40 publications

Outcome of Total Knee Replacement via Two Approaches in Indian Scenario

Outcome of Total Knee Replacement via Two Approaches in Indian Scenario

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

Subvastus Versus Medial Parapatellar Approach in Total Knee Arthroplasty: Meta-analysis

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