title: Does the length of incision in the quadriceps affect the recovery of strength after total knee replacement? a prospective randomised clinical trial.
abstract: We have compared the time to recovery of isokinetic quadriceps strength after total knee replacement (TKR) using three different lengths of incision in the quadriceps. We prospectively randomised 60 patients into one of the three groups according to the length of incision in the quadriceps above the upper border of the patella (2 cm, 4 cm or 6 cm). The strength of the knees was measured pre-operatively and every month post-operatively until the peak quadriceps torque returned to its pre-operative level. There was no significant difference in the mean operating time, blood loss, hospital stay, alignment or pre-operative isokinetic quadriceps strength between the three groups. Using the Kaplan-Meier method, group A had a similar mean recovery time to group B (2.0 ± 0.2 vs 2.5 ± 0.2 months, p = 0.176). Group C required a significantly longer recovery time (3.4 ± 0.3 months) than the other groups (p < 0.03). However, there were no significant differences in the mean Oxford knee scores one year post-operatively between the groups. We conclude that an incision of up to 4 cm in the quadriceps does not delay the recovery of its isokinetic strength after TKR.
authors.affiliation: Siriraj Hospital, Department of Orthopaedic Surgery, Faculty of Medicine, Mahidol University, Bangkok, Thailand.
authors.forename: K
authors.initials: K
authors.lastname: Chareancholvanich
authors.affiliation: Siriraj Hospital, Department of Orthopaedic Surgery, Faculty of Medicine, Mahidol University, Bangkok, Thailand.
authors.forename: C
authors.initials: C
authors.lastname: Pornrattanamaneewong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D053580:Muscle Strength; D011446:Prospective Studies; D052097:Quadriceps Muscle / Q000503:physiopathology* / Q000601:surgery*; D020127:Recovery of Function
keywords: Isokinetic strength; Knee arthroplasty; Osteoarthritis; RCT