Are There Any Clinical and Radiographic Differences Between Quadriceps-sparing and Mini-medial Parapatellar Approaches in Total Knee Arthroplasty After a Minimum 5 Years of Follow-up?

Abstract

Background:Although the early clinical outcomes of total knee arthroplasty (TKA) using minimally invasive surgery techniques have been widely described, data on the mid- to long-term outcomes are limited. We designed a retrospective study to compare the two most common TKA techniques – The modified quadriceps-sparing (m-QS) approach and the mini-medial parapatellar (MMP) approach – In terms of the clinical and radiographic parameters, over a minimum follow-up period of 5 years.Methods:The m-QS approach was used in 31 knees and the MMP approach, in 36 knees. Knees in both groups were compared for component position and alignment, knee alignment, length of the skin incision, range of motion, Visual Analog Scale score, muscle torques, Knee Society Score, Western Ontario and McMaster Universities Osteoarthritis Index, and number of complications.Results:There were no major intergroup differences in any of the clinical and radiographic outcomes assessed at the final follow-up examination.Conclusions:On the basis of numbers studied, the m-QS group, which requires more technique, showed equivalent results with the MMP group in the postoperative 5 years. Preservation of the extensor mechanism in the m-QS approach could not ensure any improvement in the clinical outcomes during the mid-term follow-up duration.

Comparisons of the Efficacy and Safety of Total Knee Arthroplasty by Different Surgical Approaches: A Systematic Review and Network Meta‐analysis

“…A total of 1678 relevant studies were obtained in the initial search of the PubMed (n = 190), EMBASE (n = 477), Cochrane Library (n = 531), and Web of Science (n = 460) databases, as well as from manual retrieval (n = 20). After excluding duplicate literature and applying the inclusion criteria and exclusion criteria, 51 RCTs 15, were finally included in this study, of which 42 15,[29][30][31][32][33][34][35][36][37][39][40][41][42][43][44][45][46][47][49][50][51][52][53][54][55][56][57][58][59][62][63][65][66][67][70][71][72][73][74][75][76] were clearly approved by ethics committees, while the approval of nine was not reported. Two three-arm tests were included in the analysis, while the remainder were all two-arm tests.…”

Comparison of minimally invasive approaches and standard median parapatellar approach for total knee arthroplasty: A systematic review and network meta-analysis of randomized controlled trials

“…Notably, Heekin [49] and Sun [48] reported significant better quadricep strength in the mini-MV group as measured by Cybex testing and straight leg raise whereas Zhang [47] and Liu [44] did not. In terms of QS vs. mini-MPP, Hung et al reported no significant difference in any of the clinical (VAS, KSS, ROM) and radiographic outcomes after a minimum of five years of follow-up [50,51]. Lin reported similar results with a shorter follow-up from postoperative 24 hours to two years [12].…”

Minimally invasive versus conventional approaches in total knee replacement/arthroplasty: A review of the literature

“…[23][24][25] Currently, many well-designed studies have tried to demonstrate the advantages/disadvantages, the clinical results and the complications of the MIS approaches compared to the MPP approach. [26][27][28][29] In this article we will review the current literature (based on randomized controlled trials (RCTs), systematic reviews and meta-analyses) on MIS compared to traditional approach and analyse their clinical safety, efficacy and long-term results.…”