Comparison of the mini-midvastus with the mini-medial parapatellar approach in primary TKA.
A prospective randomized study was performed to compare the clinical and radiological results of primary total knee arthroplasties (TKAs) using a mini-midvastus approach or a mini-medial parapatellar approach in 134 patients. The mini-midvastus approach was used on 68 patients (group A) and the mini-medial parapatellar approach on 66 patients (group B). All knees were implanted with the same posterior-stabilized prosthesis by the same surgeon (T.-S.T.) with the same set of downsized instruments. Mean follow-up in both groups was 30.5 months (range, 24-48 months). Patients in group A achieved an active straight-leg raise and 90° of flexion significantly earlier (P=.017 and P=.025, respectively). However, no significant difference was detected between the groups with respect to range of movement and Knee Society scores at all the postoperative visits and at final follow-up (all, P>.05). In contrast, the tourniquet time was significantly longer in group A (P=.015), with a higher incidence of medialized tibial component (P=.031). We believe that the early clinical results are similar between the mini-midvastus and mini-medial parapatellar approach. The mini-medial parapatellar approach is easier to initially apply and provides better visualization for TKA.
Department of Orthopedic Surgery, First Affiliated Hospital of Suzhou University, Suzhou, China.
Xi-gong
XG
Li
Tian-si
TS
Tang
Zhong-lai
ZL
Qian
Li-xin
LX
Huang
Wen-ming
WM
Pan
Ruo-fu
RF
Zhu
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods* / Q000534:rehabilitation; D005260:Female; D006801:Humans; D016916:Joint Deformities, Acquired / Q000601:surgery; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods* / Q000534:rehabilitation; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000601:surgery; D010329:Patella / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D052097:Quadriceps Muscle / Q000601:surgery*; D016059:Range of Motion, Articular; D016896:Treatment Outcome