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Does surgical approach affect patient outcomes of total knee arthroplasty?
BACKGROUND: Surgical approaches for total knee arthroplasty (TKA) include the medial parapatellar (MPA), subvastus (SV), midvastus (MV), and lateral parapatellar approach (LPA); it remains unclear which approach is superior. METHODS: Patients having undergone TKA at our institution were retrospectiv...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
CMA Joule Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8526133/ https://www.ncbi.nlm.nih.gov/pubmed/34598930 http://dx.doi.org/10.1503/cjs.010920 |
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author | Sidhu, Sahil Prabhnoor Somerville, Lyndsay E. Sidhu, Aamir Sohail Willing, Ryan T. Teeter, Matthew G. Lanting, Brent A. |
author_facet | Sidhu, Sahil Prabhnoor Somerville, Lyndsay E. Sidhu, Aamir Sohail Willing, Ryan T. Teeter, Matthew G. Lanting, Brent A. |
author_sort | Sidhu, Sahil Prabhnoor |
collection | PubMed |
description | BACKGROUND: Surgical approaches for total knee arthroplasty (TKA) include the medial parapatellar (MPA), subvastus (SV), midvastus (MV), and lateral parapatellar approach (LPA); it remains unclear which approach is superior. METHODS: Patients having undergone TKA at our institution were retrospectively organized into matched groups according to surgical approach (MPA, MV, SV, or LPA). Outcomes between the groups were compared using the Short-Form 12 (SF-12), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Society Score (KSS), and range of motion (ROM) up to 2 years postoperative. RESULTS: Sixty-eight MV patients, 8 SV patients, and 4 LPA patients were matched with groups of MPA patients. There was no difference in outcomes between the MPA and MV groups up to 2 years. The SV group had significantly higher SF-12 Physical Composite Score (PCS; p = 0.036) and WOMAC stiffness score (p = 0.014) at 2 years, but significantly lower flexion at 1 year (p = 0.022) than the MPA group. The LPA group had significantly lower SF-12 PCS (p = 0.011) and WOMAC function scores (p = 0.022) at 1 year than the MPA group. CONCLUSION: There was no significant difference between the MPA and MV approach. The SV approach had some improved long-term outcomes over the MPA aproach (SF-12 and WOMAC), but had significantly lower flexion at 1 year. The LPA group showed inferior outcomes than the MPA group but had more severe valgus preoperative deformity (p = 0.024). Further studies are required to investigate the potential benefit of quadriceps-sparing approaches. |
format | Online Article Text |
id | pubmed-8526133 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | CMA Joule Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-85261332021-10-22 Does surgical approach affect patient outcomes of total knee arthroplasty? Sidhu, Sahil Prabhnoor Somerville, Lyndsay E. Sidhu, Aamir Sohail Willing, Ryan T. Teeter, Matthew G. Lanting, Brent A. Can J Surg Research BACKGROUND: Surgical approaches for total knee arthroplasty (TKA) include the medial parapatellar (MPA), subvastus (SV), midvastus (MV), and lateral parapatellar approach (LPA); it remains unclear which approach is superior. METHODS: Patients having undergone TKA at our institution were retrospectively organized into matched groups according to surgical approach (MPA, MV, SV, or LPA). Outcomes between the groups were compared using the Short-Form 12 (SF-12), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Society Score (KSS), and range of motion (ROM) up to 2 years postoperative. RESULTS: Sixty-eight MV patients, 8 SV patients, and 4 LPA patients were matched with groups of MPA patients. There was no difference in outcomes between the MPA and MV groups up to 2 years. The SV group had significantly higher SF-12 Physical Composite Score (PCS; p = 0.036) and WOMAC stiffness score (p = 0.014) at 2 years, but significantly lower flexion at 1 year (p = 0.022) than the MPA group. The LPA group had significantly lower SF-12 PCS (p = 0.011) and WOMAC function scores (p = 0.022) at 1 year than the MPA group. CONCLUSION: There was no significant difference between the MPA and MV approach. The SV approach had some improved long-term outcomes over the MPA aproach (SF-12 and WOMAC), but had significantly lower flexion at 1 year. The LPA group showed inferior outcomes than the MPA group but had more severe valgus preoperative deformity (p = 0.024). Further studies are required to investigate the potential benefit of quadriceps-sparing approaches. CMA Joule Inc. 2021-10-01 /pmc/articles/PMC8526133/ /pubmed/34598930 http://dx.doi.org/10.1503/cjs.010920 Text en © 2021 CMA Joule Inc. or its licensors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY-NC-ND 4.0) licence, which permits use, distribution and reproduction in any medium, provided that the original publication is properly cited, the use is noncommercial (i.e., research or educational use), and no modifications or adaptations are made. See: https://creativecommons.org/licenses/by-nc-nd/4.0/ |
spellingShingle | Research Sidhu, Sahil Prabhnoor Somerville, Lyndsay E. Sidhu, Aamir Sohail Willing, Ryan T. Teeter, Matthew G. Lanting, Brent A. Does surgical approach affect patient outcomes of total knee arthroplasty? |
title | Does surgical approach affect patient outcomes of total knee arthroplasty? |
title_full | Does surgical approach affect patient outcomes of total knee arthroplasty? |
title_fullStr | Does surgical approach affect patient outcomes of total knee arthroplasty? |
title_full_unstemmed | Does surgical approach affect patient outcomes of total knee arthroplasty? |
title_short | Does surgical approach affect patient outcomes of total knee arthroplasty? |
title_sort | does surgical approach affect patient outcomes of total knee arthroplasty? |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8526133/ https://www.ncbi.nlm.nih.gov/pubmed/34598930 http://dx.doi.org/10.1503/cjs.010920 |
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