Quadriceps-sparing, minimal-incision total knee arthroplasty: a comparative study

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Musculoskeletal Research

Background:

• Total knee arthroplasty (TKA) is a common procedure for osteoarthritis.
• Minimally invasive surgical approaches aim to improve patient recovery and outcomes.
• Comparing different minimal-incision techniques is crucial for optimizing TKA procedures.

Purpose of the Study:

• To compare radiographic alignments and functional outcomes of two minimal-incision TKA approaches.
• Evaluate the medial parapatellar (MP) versus the quadriceps-sparing (QS) technique.
• Assess the impact of surgical approach on component positioning and patient function.

Main Methods:

• A randomized controlled trial involving 60 patients (80 knees) with primary osteoarthritis.
• Patients were assigned to either the minimal-incision medial parapatellar (MP) or quadriceps-sparing (QS) TKA approach.
• Radiographic alignment and short-term functional outcomes were assessed postoperatively.

Main Results:

• The QS approach showed significantly less valgus femoral component alignment and more varus tibial component alignment compared to the MP approach.
• The QS approach resulted in a more varus overall hip-knee-ankle axis and longer surgical time.
• No significant differences were found in short-term isokinetic peak muscle torque, postoperative pain, or functional outcomes between the two groups.

Conclusions:

• While the QS approach may lead to less optimal radiographic alignment in TKA, it does not appear to compromise short-term functional outcomes or pain levels compared to the MP approach.
• Careful consideration of component positioning is necessary with the QS technique.
• Both minimal-incision approaches offer comparable short-term functional recovery for patients undergoing TKA.