Difference in stair negotiation ability based on TKA surgical approach

Several surgical approaches for total knee arthroplasty (TKA) have been developed to minimize soft-tissue trauma and expedite functional recovery. A group of 61 subjects undergoing computer-navigated, minimally invasive TKA were randomized to receive a mini-parapatellar, standard parapatellar, mini-midvastus (MV), or mini-subvastus approach. Before and after treatment, subjects were asked to negotiate stairs in a self-selected manner. This study used the manner of stair negotiation (i.e., use of handrail, step-over-step, step-by-step) as a proxy for functional ability. Subjects who received TKA through a mini-MV approach demonstrated a significantly lower level of function at 2 and 4 months. If early functional recovery is a goal of TKA, surgeons should be cautious when considering the mini-MV approach, which was found to be inferior to other approaches in this study.