Minimally Invasive Subvastus Approach: Improving the Results of Total Knee Arthroplasty: A Prospective, Randomized Trial

被引:58
作者
Ramon Varela-Egocheaga, Jose [1 ]
Angel Suarez-Suarez, Miguel [2 ,3 ]
Fernandez-Villan, Maria [2 ]
Gonzalez-Sastre, Vanessa [2 ]
Ramon Varela-Gomez, Jose [4 ]
Rodriguez-Merchan, Carlos [5 ]
机构
[1] Hosp Navarra, Serv Cirugia Ortoped & Traumatol, Navarra 31008, Spain
[2] Hosp Cabuenes, Dept Orthopaed Surg, Gijon, Spain
[3] Univ Oviedo, Oviedo, Spain
[4] Hosp Alvarez Buylla, Dept Orthopaed Surg, Mieres, Spain
[5] Hosp La Paz, Dept Orthopaed Surg, Madrid, Spain
关键词
COMPONENT MALALIGNMENT; MINI-SUBVASTUS; INCREASE RISK; INCISION; REPLACEMENT; EXPERIENCE; ANATOMY; TKA;
D O I
10.1007/s11999-009-1160-8
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
100224 [整形外科学];
摘要
Minimally invasive knee arthroplasty seeks to diminish the problems of traditional extensile exposures aiming for more rapid rehabilitation of patients after surgery. To determine if the subvastus approach results in less perioperative pain and blood loss, shorter hospital stay, and improved function at both early and long-term followup. One hundred patients were enrolled in a prospective, randomized trial. Fifty were operated on using a minimally invasive subvastus approach and the other 50 by a conventional, peripatellar approach. Minimum followup was 3 years. A repeated-measures analysis of variance was used to compare the Knee Society score and range of motion during followup. The minimally invasive approach resulted in greater perioperative bleeding but no increase in transfusions. No differences were found in postoperative pain between groups nor did hospital stay show any differences. The range of motion on the third day after surgery was greater in the minimally invasive group. No differences were found in surgical time, femoral or tibial component orientation or outliers, or complication rates. Both Knee Society score and range of motion were superior using the minimally invasive subvastus approach during followup out to 36 months. The minimally invasive subvastus approach can result in improved long-term Knee Society scores and range of motion of total knee arthroplasty without increased risk of component malalignment, surgical time, or complication rate. Level I, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
引用
收藏
页码:1200 / 1208
页数:9
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