The Early Clinical Outcome of Minimally Invasive Quadriceps-Sparing Total Knee Arthroplasty

Huang, Hsuan-Ti; Su, Jiing Yuan; Chang, Je-Ken; Ch, Chen; Wang, Gwo-Jaw

doi:10.1016/j.arth.2007.03.021

Cited by 62 publications

(71 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Others found equal extensor torque among patients who had MIS and standard TKAs 3 and 6 months postoperatively, but better torque in patients who had MIS after 1 year [23], or they reported better results at 3 and 6 months postoperatively among patients who had MIS [5]. Summarizing the above-mentioned studies and including our findings, we believe the evidence shows better quadriceps function with MIS TKA for the first postoperative month [8,16,33,37,44], and scant evidence for any differences in quadriceps strength in the longer term [5,20,23,25,37]. It is unclear to what extent the different types of MIS approach used in the above-mentioned studies might have contributed to discrepancies.…”

Section: Discussionsupporting

confidence: 71%

“…Of the studies reporting on quadriceps function in terms of achievement of rehabilitation milestones [8,16,20,25,33], the majority reported superior quadriceps function for MIS TKA in the first postoperative week [8,16,33]. Only a few studies reported on quadriceps function in terms of rehabilitation milestones beyond the first postoperative week; Kolisek et al [25] found no strength differences 12 weeks after surgery.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 94%

“…Many authors assessed quadriceps function in terms of rehabilitation milestones (eg, straight leg raise) after MIS and standard TKAs [8,16,20,25,33]. The findings in those studies are consistent, in that quadriceps function was superior with a MIS TKA during the first postoperative week [8,16,33]. Only a few studies reported on quadriceps function in terms of rehabilitation milestones beyond the first postoperative week; Kolisek et al [25] reported no strength differences 12 weeks after surgery, and the strength findings observed by Karpman and Smith [20] 2 weeks postoperative were dependent on the type of MIS approach (quadriceps-sparing superior, but mini-midvastus not superior as compared with medial parapatellar).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Does Minimally Invasive Total Knee Arthroplasty Improve Isokinetic Torque?

Liebensteiner

Krismer

Koller³

et al. 2012

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Less invasive dissection of the extensor apparatus, one of the aspects of minimally invasive surgical (MIS) TKA, might result in less reduction of postoperative quadriceps strength. However, it is unclear whether MIS is associated with less strength reduction. Questions/purposes We asked whether knee strength (extensor or flexor torque) would be greater in patients having a MIS TKA compared with patients having a standard TKA and whether knee scores, alignment, ROM, tourniquet and operating times, and hospital length of stay were improved. Methods We prospectively recruited 52 patients awaiting MIS or standard TKA, matched for age, weight, height, BMI, sex, and surgically treated side, but not randomized. Isokinetic tests were performed preoperatively and postoperatively to obtain peak values of extensor and flexor torque. Postoperative-to-preoperative ratios and the extensor-flexor torque ratio also were calculated. Results Mean baseline extensor torques were 57 Nm and 53 Nm for MIS and standard TKAs, respectively. At 8 weeks postoperatively, absolute values of the mean postoperative knee extensor torque also were similar: 47 and 45 Nm for patients with MIS and standard TKAs, respectively. The postoperative-to-preoperative ratios were 0.8 for extensor and flexor torque in both groups. The extensor-flexor torque ratios were similar between groups. Conclusions Our data suggest a less invasive dissection of the extensor apparatus involved in MIS TKA does not enhance postoperative quadriceps strength. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

show abstract

Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Does Minimally Invasive Total Knee Arthroplasty Improve Isokinetic Torque?

Liebensteiner

Krismer

Koller³

et al. 2012

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…Several MIS TKA techniques have been described: traditional mini (mini-medial parapatellar [15], mini-midvastus [20,21], mini-subvastus [22,43]) and fully innovative techniques (quad-sparing) [25,39,48]. Advocates of MIS TKA commonly suggest it allows patients faster recovery time [9,15], less blood loss [20], decreased soft tissue trauma [30,37], more pain relief [18], better cosmetic appearance [15,18,26], and measurable improvement of function [9,15,48]. Critics of MIS TKA emphasize possible complications associated with long-term outcomes (eg, lower survival rates) and the length of the learning curve [31,38].…”

Section: Introductionmentioning

confidence: 99%

Does Minimally Invasive Surgery Improve Short-term Recovery in Total Knee Arthroplasty?

Cheng

Liu

Zhang

et al. 2010

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Concerns have been raised regarding minimally invasive surgery (MIS) and its possible effect on postoperative functional recovery, complications, and survival rate after TKA. Questions/purposes We specifically asked whether MIS TKA would be associated with (1) increased operative time, (2) reduced blood loss, (3) shortened hospital stay, (4) faster recovery of ROM, (5) higher knee scores, (6) inferior component positioning, and (7) increased complications. Methods We performed a systematic literature search of randomized controlled trials between minimally invasive and standard approaches in TKA that compared operative time, blood loss, ROM, knee scores, component positioning, and complications. We conducted a systematic review and meta-analysis of 13 trials published from 2007 to 2009 of MIS versus standard TKA.

show abstract