title: Applicability of the mini-subvastus total knee arthroplasty technique: an analysis of 725 cases with mean 2-year follow-up.
abstract: Recent total knee arthroplasty (TKA) studies suggest a more rapid functional recovery with minimally invasive surgical (MIS) techniques. These studies often fail to disclose the percentage of primary TKA that underwent the MIS technique, raising the concern that positive clinical outcomes are a result of patient selection. This study evaluates the applicability of the mini-subvastus technique in one surgeon's consecutive primary TKA patients. The applicability was determined utilizing a computer record review to determine the percentage of primary TKA patients in which the surgeon utilized a MIS surgical technique. The mini-subvastus approach was applied to 99% of 732 consecutive primary TKA. There was no patient selection based on age or weight. Traditional TKA, utilizing a medial parapatellar arthrotomy, was more likely to be performed on patients with a diagnosis of traumatic arthritis and in knees that required stems or augments. Preoperative tibiofemoral angle and mean knee deformity were not predictors of which procedure would be utilized. Despite employing this new surgical approach in nearly all primary TKAs, there was no increase in the complication rate. This high applicability rate with the mini-subvastus technique obviates concerns that the positive clinical outcomes in these patients are a result of patient selection.
authors.affiliation: St. Louis Joint Replacement Institute, Premier Care Orthopedics, 12266 DePaul Drive, Suite 220, Saint Louis, MO 63044, USA. drschroer@yahoo.com
authors.forename: William C
authors.initials: WC
authors.lastname: Schroer
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Diesfeld
authors.forename: Angela
authors.initials: A
authors.lastname: LeMarr
authors.forename: Mary E
authors.initials: ME
authors.lastname: Reedy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000209:etiology / Q000601:surgery; D001172:Arthritis, Rheumatoid / Q000601:surgery; D019645:Arthroplasty, Replacement, Knee / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D005264:Femoral Fractures / Q000150:complications; D005269:Femur / Q000601:surgery; D005500:Follow-Up Studies; D017759:Fractures, Malunited / Q000150:complications; D005599:Fractures, Ununited / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods / Q000706:statistics & numerical data; D020370:Osteoarthritis, Knee / Q000601:surgery; D010329:Patella / Q000601:surgery; D018579:Patient Selection; D011183:Postoperative Complications; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology; D013977:Tibia / Q000601:surgery; D016896:Treatment Outcome