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[Minimally invasive total knee arthroplasty through a quadriceps sparing approach: a comparative study]
Hao Shen1, Xian-long Zhang, Qi Wang
1Department of Orthopaedics Surgery, Shanghai the Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China.
Zhonghua Wai Ke Za Zhi [Chinese Journal of Surgery]
|November 17, 2007
Summary
Minimally invasive total knee arthroplasty (MIS-TKA) using a quadriceps sparing (QS) approach shows faster recovery and better range of motion compared to standard TKA. However, the QS technique requires specific patient indications for optimal outcomes.
Area of Science:
- Orthopedic Surgery
- Minimally Invasive Procedures
- Arthroplasty
Background:
- Total knee arthroplasty (TKA) is a common procedure for knee osteoarthritis.
- Traditional TKA approaches can involve significant soft tissue disruption.
- Minimally invasive techniques aim to reduce surgical trauma and improve patient recovery.
Purpose of the Study:
- To compare the short-term clinical outcomes of minimally invasive total knee arthroplasty (MIS-TKA) utilizing a quadriceps sparing (QS) approach.
- To evaluate MIS-TKA (QS) against standard TKA with a medial parapatellar exposure.
Main Methods:
- A cohort of 26 unilateral primary MIS-TKA (QS) patients were compared to an age- and sex-matched standard TKA cohort.
- Evaluated parameters included incision length, tourniquet time, blood loss, range of motion (flexion), visual analog scale (VAS) pain scores, Knee Society scores, tibiofemoral angle, and straight leg raise ability.
- Follow-up duration averaged 17 months.
Main Results:
- MIS-TKA (QS) resulted in significantly shorter incisions (9.5 cm vs. 14.0 cm) and longer tourniquet times (83 min vs. 55 min).
- QS group demonstrated lower VAS scores at early postoperative days and improved early flexion (107° vs. 95°) and straight leg raise ability (88% vs. 64%).
- Knee Society scores at 6 weeks were higher in the QS group (78 vs. 71), with no significant long-term differences in range of motion or alignment.
Conclusions:
- MIS-TKA through a quadriceps sparing (QS) approach facilitates quicker functional recovery and enhanced range of motion.
- The QS technique necessitates careful patient selection and adherence to specific indications for successful implementation.