title: Progressive quadriceps incision during minimally invasive surgery for total knee arthroplasty: the effect on early postoperative ambulation.
abstract: A prospective series of 114 consecutive minimally invasive surgeries for total knee arthroplasty was performed using the quadriceps-sparing approach at the beginning. Intraoperatively, when the knee was in 45 degrees to 60 degrees of flexion, lateral patella subluxation was evaluated. A progressive quadriceps tendon incision with a 1-cm increment was applied if the patella could not be completely slid. The mean follow-up time was 24 months. There were 3 groups according to the length of quadriceps incision: group A (17 knees) had no or 1-cm quadriceps incision; group B (60 knees) had 2-cm incision; and group C (37 knees) had 3-cm incision. The average operative time, blood loss, pain score, preoperative range of motion and postoperative range of motion at 2 weeks, 6 weeks, 12 weeks, and 3 months were not significantly different among groups. Patient ability for early ambulation (sitting, knee straightening, standing, and walking) was indifferent between groups A and B; however, this was significantly delayed in group C. In conclusion, minimally invasive surgery for total knee arthroplasty with 2-cm quadriceps incision or strict quadriceps-sparing approach provided no difference on early ambulation.
authors.affiliation: Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Aree
authors.initials: A
authors.lastname: Tanavalee
authors.forename: Satit
authors.initials: S
authors.lastname: Thiengwittayaporn
authors.forename: Pibul
authors.initials: P
authors.lastname: Itiravivong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods* / Q000534:rehabilitation*; D001696:Biomechanical Phenomena; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000502:physiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010329:Patella / Q000502:physiology / Q000601:surgery; D011446:Prospective Studies; D052097:Quadriceps Muscle / Q000502:physiology / Q000601:surgery*; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*