title: Mini-midvastus vs standard medial parapatellar approach: a prospective, randomized, double-blinded study in patients undergoing bilateral total knee arthroplasty.
abstract: The purpose of this study was to determine whether the mini-midvastus approach to total knee arthroplasty (TKA) results in differences in quadriceps muscle strength as well as previously cited advantages in a double blind prospective randomized trial. Twenty-seven patients (54 TKAs) scheduled for bilateral TKA were randomized to undergo mini-midvastus approach on one knee and standard approach on the other. Incision lengths were the same. Postoperative strength was determined by isokinetic and isometric peak torque testing. Range of motion, pain Visual analog scale, side-preference, and gait analysis were assessed preoperatively and postoperatively. The only significant difference in strength testing was increased isokinetic and isometric extension torque at 3 weeks postoperatively for the mini-midvastus approach. No differences between the mini-midvastus and standard approach were observed for stride length, stance time, pain Visual analog scale, or knee range of motion. The mini-midvastus approach has limited benefit compared to the standard approach for TKA.
authors.affiliation: Adult Reconstruction and Joint Replacement Division, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York 10021, USA.
authors.forename: Bryan J
authors.initials: BJ
authors.lastname: Nestor
authors.forename: Charles E
authors.initials: CE
authors.lastname: Toulson
authors.forename: Sherry I
authors.initials: SI
authors.lastname: Backus
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Lyman
authors.forename: Kristin L
authors.initials: KL
authors.lastname: Foote
authors.forename: Russell E
authors.initials: RE
authors.lastname: Windsor
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D053580:Muscle Strength / Q000502:physiology; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000601:surgery*; D010149:Postoperative Pain / Q000503:physiopathology; D010329:Patella / Q000601:surgery*; D011446:Prospective Studies; D052097:Quadriceps Muscle / Q000601:surgery*; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D016896:Treatment Outcome