Total knee arthroplasty: Comparison between quadriceps sparing approach and medial parapatellar approach

doi:10.3969/j.issn.2095-4344.2013.35.004

Abstract

Abstract:

BACKGROUND: Now, domestic total knee arthroplasty surgeries mainly use medial parapatellar approach, with the disadvantages of large trauma and slower recovery. The quadriceps sparing approach is more accorded with normal anatomy, which can keep the knee extension system intact. The clinical comparison between quadriceps sparing approach and medial parapatellar approach is rare.
OBJECTIVE: To compare the early effect of total knee arthroplasty through quadriceps sparing approach and medial parapatellar approach.
METHODS: From January 2009 to January 2010, 55 patients (70 knees) were randomly divided into quadriceps sparing approach group (n=26, 35 knees) and medial parapatellar approach group (n=29, 35 knees). Patients in two groups received total knee arthroplasty through quadriceps sparing approach and medial parapatellar approach respectively. The incision length, operative time, postoperative drainage volume, additional amount of etoricoxib tablets, pain degree, straight leg raising time, start walking time, hospitalization time, range of motion of knee joint, Hospital for Special Surgery Knee Score, radiographic alignment of all components and complications were compared between two groups. All the prostheses used in this study were the Sigma type prostheses provided by the rotation platform of Johnson&Johnson Company.
RESULTS AND CONCLUSION: All the patients were followed-up for 12-24 months without infections, deep vein thrombosis, neurovascular injury, prosthesis instability, prosthesis loosening or displacement. Position of all the prostheses was normal in patients. The operative time in the quadriceps sparing approach group was longer than that in the medial parapatellar approach group (P=0.00), while the incision length, postoperative drainage volume, additional amount of etoricoxib tablets, visual analog scale, straight leg raising time, start walking time, hospitalization time, range of motion of knee joint at 3 days after replacement and Hospital for Special Surgery Knee Score in the quadriceps sparing approach group were better than those in the medial parapatellar approach group (P < 0.05). There were no significant differences in range of motion of knee joint at 3 days after replacement and Hospital for Special Surgery Knee Score between two groups. The early effect of total knee arthroplasty through quadriceps sparing approach is better than the medial parapatellar approach, and there is no significant difference in prosthesis alignment between two methods.

Key words: bone and joint implants, artificial prosthesis, total knee arthroplasty, knee joint, approach, quadriceps sparing, medial parapatellar, extensor mechanism, early effect, comparative research

CLC Number:

R318

Xu Jie, Liu Chun-hua, Zhou Shi-guo, Lin Yuan. Total knee arthroplasty: Comparison between quadriceps sparing approach and medial parapatellar approach[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(35): 6240-6246.

Figures/Tables 7

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