title: Total knee replacement performed with either a mini-midvastus or a standard approach: a prospective randomised clinical and radiological trial.
abstract: We report the clinical and radiological results of a two- to three-year prospective randomised study which was designed to compare a minimally-invasive technique with a standard technique in total knee replacement and was undertaken between January 2004 and May 2007. The mini-midvastus approach was used on 50 patients (group A) and a standard approach on 50 patients (group B). The mean follow-up in both groups was 23 months (24 to 35). The functional outcome was better in group A up to nine months after operation, as shown by statistically significant differences in the mean function score, mean total score and the mean Oxford knee score (all, p = 0.05). Patients in group A had statistically significant greater early flexion (p = 0.04) and reached their greatest mean knee flexion of 126.5 degrees (95 degrees to 135 degrees ) 21 days after operation. However, at final follow-up there was no significant difference in the mean maximum flexion between the groups (p = 0.08). Technical errors were identified in six patients from group A (12%) on radiological evaluation. Based on these results, the authors currently use minimally-invasive techniques in total knee replacement in selected cases only.
authors.affiliation: Orthopaedic Department School of Medicine, Faculty of Health Sciences, University of Thessaly, 22 Papakyriazi Street, Larissa 41222, Greece. kar@med.uth.gr
authors.forename: Th
authors.initials: T
authors.lastname: Karachalios
authors.forename: D
authors.initials: D
authors.lastname: Giotikas
authors.forename: N
authors.initials: N
authors.lastname: Roidis
authors.forename: L
authors.initials: L
authors.lastname: Poultsides
authors.forename: K
authors.initials: K
authors.lastname: Bargiotas
authors.forename: K N
authors.initials: KN
authors.lastname: Malizos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000601:surgery*; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular; D013223:Statistics as Topic; D016896:Treatment Outcome