V-Y quadricepsplasty in total knee arthroplasty

Area of Science:

• Orthopedic Surgery
• Biomechanics
• Reconstructive Surgery

Background:

• Total knee arthroplasty (TKA) is a common procedure for end-stage knee arthritis.
• V-Y quadricepsplasty is a surgical approach sometimes required during TKA.
• The functional outcomes and biomechanical effects of V-Y quadricepsplasty in TKA are not fully understood.

Purpose of the Study:

• To evaluate the clinical outcomes and biomechanical performance of total knee arthroplasty (TKA) utilizing a V-Y quadricepsplasty approach.
• To compare the functional results of V-Y quadricepsplasty TKA with contralateral normal knees and standard TKA procedures.

Main Methods:

• Retrospective review of 14 patients (16 knees) who underwent TKA with V-Y quadricepsplasty.
• Clinical evaluation using the Hospital for Special Surgery knee rating score and active range of motion.
• Biomechanical testing of knee extensor strength using the Cybex-II system at a mean of 3 years post-surgery.

Main Results:

• Overall, 12 out of 14 patients achieved good or excellent results based on the Hospital for Special Surgery score.
• Average active range of motion was 4 to 85 degrees.
• Biomechanical testing showed statistically significant weakness in extension at higher speeds compared to contralateral normal knees, though overall extensor mechanism weakness was not significant compared to standard TKA.

Conclusions:

• Total knee arthroplasty with V-Y quadricepsplasty can yield satisfactory clinical outcomes and near-normal active extension.
• Moderate weakness in knee extension is expected, particularly at higher testing velocities.
• The V-Y quadricepsplasty approach presents reconstructive challenges, reflected in patient outcomes.