Surgical approaches in total knee arthroplasty

Khan, Riaz J.K.; Keogh, Angus; Fick, Daniel; Wood, David

doi:10.1002/14651858.cd005329

Cited by 6 publications

(3 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Surgical approach: Surgical approaches in TKA include the traditional medial parapatellar [ 44 ], the subvastus surgical approach, characterized by quadriceps preservation [ 45 ] and midvastus surgical approach, a compromise between medial parapatellar and subvastus approach [ 46 ]. The surgical approaches have recently been reviewed in a Cochrane Systematic Review protocol [ 47 ]. The majority of surgeons responded that the surgical approach had no significant impact on patient outcome after TKA, in line with the current literature [ 48 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

Recommendations for Patients with High Return to Sports Expectations after TKA Remain Controversial

Vu-Han

Gwinner

Perka

et al. 2020

JCM

View full text Add to dashboard Cite

(1) Background: Improved surgical techniques and implants in total knee arthroplasty (TKA) have led to broader indications for surgical interventions of osteoarthritis of the knee. There is a growing young and active patient subgroup with high return to sports (RTS) expectations after TKA. The current lack of evidence regarding RTS capacity in this patient cohort, requires the consolidation of experts’ opinions and experiences to address the special needs among these patients. The aim of this study was to assess current expert opinions in regard to preoperative patient assessment, surgical technique and decision-making and patient counseling for these patients. (2) Methods: We performed a survey among surgeons specialized in arthroplasty with a questionnaire designed to assess current recommendations, surgical techniques, and implant preferences as well as patient counseling in patients with high expectations for RTS after TKA. (3) Results: The majority of surgeons are in favor of return to low-impact sports after TKA within 3 to 6 months. Some even recommend return to high-impact sports. Despite improvement of surgical techniques and implants, we observed no clear preference for a single surgical technique or implant specification in active patients. (4) Conclusions: Current evidence for sports-associated complications after TKA is scarce. Despite a growing array of surgical techniques and implants, the available literature is still controversial with no single surgical technique or TKA design distinguishing itself clearly from others. Surgeons’ recommendations are mostly based on their experience and training. Nonetheless, we observed growing faith in modern implants with some surgeons even recommending high-impact sports after TKA.

show abstract

Section: Discussionmentioning

confidence: 99%

Recommendations for Patients with High Return to Sports Expectations after TKA Remain Controversial

Vu-Han

Gwinner

Perka

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

“…All patients had the same implant (Multigen Plus, Lima-Lto, San Daniele, Italy ( Figure 1(a) )) fitted using the standard surgical approach for TKA (medial parapatellar approach) [ 48 ]. Three different surgeons performed the surgery.…”

Section: Methodsmentioning

confidence: 99%

Modulation and Predictors of Periprosthetic Bone Mineral Density following Total Knee Arthroplasty

Mau-Moeller

Behrens

Felser

et al. 2015

BioMed Research International

View full text Add to dashboard Cite

Total knee arthroplasty (TKA) leads to a loss of periprosthetic bone mineral density (BMD). Great importance is attached to the prevention of periprosthetic bone loss with a view to ensuring a long service life of the prosthesis. In order to provide appropriate recommendations for preventive movement therapy measures to combat peri-implant bone loss, it is necessary to know the predictors of periprosthetic BMD. The aim of this study was (1) to determine the change of periprosthetic BMD of the femur and tibia and (2) to analyse the effects of different predictors on periprosthetic BMD. Twenty-three patients with primary TKA were evaluated 10 days and 3 months postoperatively. The data analysis comprised (1) the change in periprosthetic BMD from pretest to posttest and (2) the correlations between BMD and the variables isometric maximum voluntary force, lean mass, physical activity (step count), and BMI using multiple linear regression and structural equation modelling (SEM). BMD of the distal femur was significantly reduced by 19.7% (P = 0.008) 3 months after surgery, while no changes were found in BMD of the tibia. The results of SEM demonstrate that 55% of the BMD variance was explained by the model (χ2 = 0.002; df = 1; P = 0.96; χ2/df = 0.002; RMSEA < 0.01; TLI = 1.5; CFI = 1.0). A significant direct effect was only evidenced by the variable lean mass (β = 0.38; b = 0.15; SE = 0.07; C.R. = 2.0; P = 0.046). It can be assumed that a large muscle mass with accompanying distribution of high mechanical load in the bones can contribute to local changes of periprosthetic BMD. Concrete recommendations for preventing peri-implant bone loss therefore include exercises which have the aim of maintaining or building up muscle mass.

show abstract

“…However, a QS technique can be more difficult in stiff knees or muscular patients, and there is a learning curve for surgeons new to the technique 1,4 . Systematic reviews have indicated that the quality of published trials is poor and no one technique can be considered superior on the basis of the available evidence 2,5 . Most studies were uncontrolled, retrospective case series with small sample sizes, utilizing a variety of outcome measures that were usually not patient-reported 6 .…”

mentioning

confidence: 99%

Early Patient Outcomes After Primary Total Knee Arthroplasty with Quadriceps-Sparing Subvastus and Medial Parapatellar Techniques

Tomek

Kantor

Cori

et al. 2014

The Journal of Bone and Joint Surgery

View full text Add to dashboard Cite

Surgical approaches in total knee arthroplasty

Cited by 6 publications

References 25 publications

Recommendations for Patients with High Return to Sports Expectations after TKA Remain Controversial

Recommendations for Patients with High Return to Sports Expectations after TKA Remain Controversial

Modulation and Predictors of Periprosthetic Bone Mineral Density following Total Knee Arthroplasty

Early Patient Outcomes After Primary Total Knee Arthroplasty with Quadriceps-Sparing Subvastus and Medial Parapatellar Techniques

Contact Info

Product

Resources

About