title: Mini-subvastus versus a standard approach in total knee arthroplasty: a prospective, randomized, controlled study.
abstract: This prospective randomized study compared the clinical and radiological results of primary total knee arthropasty (TKA) using a mini-subvastus approach (group I; n = 35) or a standard approach (group II; n = 33). A posterior-stabilized prosthesis was used in both groups by the same surgeon. Mean follow-up was 18 months (range 14 - 26 months). Patients in group I lost less blood and experienced less pain 1 day post-operatively. They achieved an active straight leg raise earlier and underwent less lateral retinacular releases. Functional outcome and the range of knee movements were significantly better in group I up to 9 months post-operatively, but there was no significant difference between the groups at 1 year post-operatively or at final follow-up. Reduced access and visibility in group I prolonged the operation time and resulted in five technical errors on radiographic evaluation. Based on these results, the authors currently only use the mini-subvastus approach for minimally invasive TKA in selected cases.
authors.affiliation: Department of Orthopaedic Surgery, First Affiliated Hospital of Suzhou University, Suzhou, China.
authors.forename: W-M
authors.initials: WM
authors.lastname: Pan
authors.forename: X-G
authors.initials: XG
authors.lastname: Li
authors.forename: T-S
authors.initials: TS
authors.lastname: Tang
authors.forename: Z-L
authors.initials: ZL
authors.lastname: Qian
authors.forename: Q
authors.initials: Q
authors.lastname: Zhang
authors.forename: C-M
authors.initials: CM
authors.lastname: Zhang
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010149:Postoperative Pain; D011446:Prospective Studies; D052097:Quadriceps Muscle / Q000601:surgery*; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome