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A Retrospective Analysis of the Modified Intervastus Approach
Muthana Sartawi, Hafizur Rahman1, James Kohlmann
1Department of Biomechanics, 6160 University Drive South, USA.
American Journal of Orthopedics (Belle Mead, N.J.)
|January 17, 2019
Summary
The modified intervastus (MIV) approach for total knee arthroplasty (TKA) demonstrates significant pain reduction and improved range of motion (ROM). This muscle-sparing technique facilitates faster independent ambulation, offering advantages over other TKA approaches.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- The subvastus (SV) approach is a recognized muscle- and tendon-sparing technique for total knee arthroplasty (TKA).
- Previous studies suggest SV offers benefits over the medial parapatellar (MP) approach regarding pain, range of motion (ROM), and rehabilitation.
- The modified intervastus (MIV) approach is a novel, extensile, and simple muscle- and tendon-sparing technique for TKA.
Purpose of the Study:
- To describe the surgical technique of the MIV approach for TKA.
- To evaluate the functional outcomes of the MIV approach in patients undergoing TKA.
- To compare the MIV approach with existing TKA surgical methods.
Main Methods:
- A prospective study involving 127 patients undergoing TKA using the MIV approach.
- Clinical outcomes including visual analog pain score (VAS) and knee range of motion (ROM) were recorded preoperatively and at multiple postoperative time points.
- Time to independent ambulation without assistive devices was measured.
Main Results:
- A significant decrease in VAS pain scores was observed from preoperative levels to postoperative day 1 (P < .05).
- Knee ROM initially decreased at 1 week but surpassed preoperative levels by 6 weeks and continued to improve over 1 year.
- One-third of patients achieved independent ambulation by 2 weeks, and 78% by 8 weeks.
Conclusions:
- The MIV approach is a muscle- and tendon-sparing technique for TKA that is technically straightforward and extensible.
- The MIV approach demonstrates favorable outcomes in pain management, ROM, and functional recovery, including early independent ambulation.
- The MIV approach presents potential advantages over the SV approach and is suitable for complex primary and revision TKA cases.
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