Avoidance of patellar eversion improves range of motion after total knee replacement: a prospective randomized study

Arnout, Nele; Victor, Jan; Cleppe, H.; Soenen, M.; Damme, Geert Van; Bellemans, Johan

doi:10.1007/s00167-009-0863-4

Cited by 21 publications

(72 citation statements)

References 18 publications

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“…No statistical differences between 2 groups throughout the follow-up periods in recovery of quadriceps force or power and clinical data Arnout et al [51] Prospective randomized study. Medial parapatellar arthrotomy with patellar eversion vs same approach without eversion Patellar dislocation without eversion improved range of motion at 1 yr postoperatively.…”

Section: Ref Type Of Study Outcomementioning

confidence: 98%

“…On the other hand, in 2009, Dalury et al [50] claimed that patellar eversion and anterior tibial translation showed no significant difference to patellar subluxation and avoiding tibial translation on range of knee motion, quadriceps strength and patient's knee preference, up to 6 mo after surgery. Furthermore, Arnout et al [51] in 2009, in a prospective randomized study, concluded that patellar dislocation without eversion improved the active and passive range of knee motion up to 1 year postoperatively and recommended this procedure as safe. Umrani et al [52] in 2013, found that patellar eversion did not significantly affect quadriceps recovery after TKA up to 1 year after surgery.…”

Section: Patellar Eversion or Not?mentioning

confidence: 99%

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Common controversies in total knee replacement surgery: Current evidence

Nikolaou¹

2014

WJO

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Total knee replacement (TKR) is a widely used operation that has radically improved the quality of life of millions of people during the last few decades. However, some technical details, concerning the surgical procedure and the rehabilitation following total knee arthroplasty, are still a matter of a strong debate. In this review of the literature, we have included the best evidence available of the last decade, in an effort to shed light on some of the most controversial subjects related to TKR surgery. Posterior-stabilized or cruciate-retaining prosthesis? To use a tourniquet during operation or not? Do patients need continuous passive motion for their post-surgery rehabilitation? To resurface patella or not? These are some of the most controversial topics that until now have been persistent dilemmas for the orthopedic surgeon. Results of this systematic review of the literature are highly controversial. These conflicting results are an indication that larger and more well conducted high quality trials are needed in order to gain more secure answers. At the same time, it is becoming apparent that a meticulous operative technique, respecting the soft tissue envelope and knowing the principles of alignment and soft tissue balancing, are some of the parameters that might contribute more to achieving the optimal results for the patients. Key words: Total knee replacement; Controversy; Literature review; Patella resurfacing; Patella eversion; Posterior stabilized; Cruciate retaining; Tourniquet; Continuous passive motion Core tip: A literature review has been conducted in an effort to present the best available evidence of the last decade and to shed light on some of the most controversial subjects related to total knee replacement surgery. Patella resurfacing or not? Posterior cruciate retaining or sacrificing? Continuous passive motion or not? Tourniquet or not? These are some of the most debatable topics that until now have been persistent dilemmas for the orthopedic surgeon. Results of this systematic review of the literature are highly controversial. These conflicting results are an indication that larger and better conducted high quality trials are needed in order to gain more secure answers.Nikolaou VS, Chytas D, Babis GC. Common controversies in total knee replacement surgery: Current evidence. World J Orthop 2014; 5(4

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Section: Ref Type Of Study Outcomementioning

confidence: 98%

Section: Patellar Eversion or Not?mentioning

confidence: 99%

Common controversies in total knee replacement surgery: Current evidence

Nikolaou¹

2014

WJO

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“…The suprapatellar pouch is no longer violated, the patella is no longer everted, and the tibia is not dislocated anteriorly [1,7,20,27,31]. Several studies were able to show earlier recovery in the short term, but most publications failed to demonstrate significant differences among the available surgical approaches [3,4,10,11,16,28,30].…”

Section: Introductionmentioning

confidence: 99%

Faster recovery after minimally invasive surgery in total knee arthroplasty

Thienpont

2012

Knee Surg Sports Traumatol Arthrosc

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Purpose The aim of the study was to identify whether less soft tissue and muscle damage during surgery will allow faster recovery after total knee arthroplasty in comparison with the conventional technique. A limited medial parapatellar approach without tibial medial collateral ligament (MCL) desinsertion was compared with the conventional parapatellar approach. Methods Three hundred patients were randomized either into the minimally invasive group (MIS group) or into the conventional group (CON group). The evaluation was based on the Knee Society Score, range of motion, blood loss, period of hospitalization and postoperative hemoglobin level. Results The MIS group showed faster recovery with immediate postoperative full weight‐bearing and shorter length of stay (5 vs 10 days). Comparable Knee Society Scores (87.5 vs 88), function scores (90) and alignment (5.5° vs 5.2°) between the CON and MIS group were observed at a follow‐up of 24 months. No increase in operative times (52 vs 51 min tourniquet time) or no complications were observed. Reduced blood loss was observed in the MIS group (590 vs 989 ml). Conclusion The MCL sparing limited medial parapatellar approach allows good surgical exposure, easy extension proximally if necessary, contained closure after surgery with less bleeding, faster recovery, full weight‐bearing without aid and most importantly no radiological malalignment. Level of evidence Therapeutic study, Level II.

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“…The reported benefits include improved range of motion (ROM) [1], earlier return of straight leg raising (SLR) [2,4,7], better early knee flexion [2], avoidance of patella baja [3,6], and shorter hospital stays [7]. However, the reproducibility of many of these studies is compromised by the subjective nature of their outcomes.…”

mentioning

confidence: 97%

“…Several previous studies have explored the advantages of avoiding eversion of the patella during total knee arthroplasty (TKA) [1][2][3][4][5][6][7]. The reported benefits include improved range of motion (ROM) [1], earlier return of straight leg raising (SLR) [2,4,7], better early knee flexion [2], avoidance of patella baja [3,6], and shorter hospital stays [7].…”

mentioning

confidence: 98%