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Bilateral Assessment of the Corticospinal Pathways of the Ankle Muscles Using Navigated Transcranial Magnetic Stimulation
Published on: February 19, 2019
Electromyographic evaluation of the midvastus approach
David F Dalury1, Robert G Snow, Mary Jo Adams
1Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD 21224-2780, USA.
The Journal of Arthroplasty
|January 1, 2008
Summary
The midvastus approach for knee arthroplasty is safe. Electromyography and nerve conduction studies showed no damage to the vastus medialis obliquus, supporting its use as an alternative surgical option.
Area of Science:
- Orthopedic Surgery
- Biomechanics
- Neurophysiology
Background:
- The midvastus approach for total knee arthroplasty (TKA) is proposed to offer easier and earlier recovery compared to the standard median parapatellar approach.
- Concerns exist regarding potential damage to the vastus medialis obliquus (VMO) muscle with the midvastus approach.
Purpose of the Study:
- To evaluate the safety of the midvastus approach in total knee arthroplasty.
- To determine if the midvastus approach causes damage to the vastus medialis obliquus (VMO) muscle using electrophysiological methods.
Main Methods:
- Prospective randomized study involving 20 patients undergoing bilateral total knee arthroplasty.
- Each patient received one knee treated with the midvastus approach and the other with the standard median parapatellar approach.
- Electromyography (EMG), nerve conduction studies (NCS), radiographs, range-of-motion, and Knee Society scores were assessed preoperatively and postoperatively at 6 and 12 weeks.
Main Results:
- Electromyography and nerve conduction studies at 6 and 12 weeks showed no evidence of muscle denervation in the vastus medialis obliquus (VMO) for either surgical approach.
- No significant differences in muscle damage were observed between the midvastus and median parapatellar approaches.
Conclusions:
- The midvastus approach is a safe alternative for knee arthrotomy in total knee arthroplasty.
- This approach does not appear to cause clinically significant damage to the vastus medialis obliquus (VMO).
