Total Knee Arthroplasty In Valgus Knees Using Minimally Invasive Subvastus Approach

Objective: To report total knee arthroplasty in valgus knees using minimally invasive subvastus approach and evaluate efficacy of subvastus approach in valgus knees in terms of early functional recovery,limb alignment and complications.Methods: from 2015.9 to 2017.3,valgus knee 19 patients using total knee arthroplasty through subvastus approach,4 man,13 women.Aged 41-73,mean 62 years.12 left valgus knee and 7 right valgus knee.Valgus Angle from 10.1-32.2 degees,mean 20.7 degrees.8 patients of Rheumatoid arthritis,11 patients of osteoarthritis.All patients used subvastus approach resect bone and balance gap tissue and install prosthsis.patients were assessed postoperatively and preoperatively radiographic,measurement of femoral tibial angle(femur-tibia angle,FTA)and compare the lower limb alignment correction.record the preoperative and postoperative knee joint activity(range of,motion,ROM),to evaluate the situation of knee joint activities.pain using Visual Analog Scale(VAS)and clinical outcomes using hospital special surgery score(HSS),quadriceps recovery in form of starting walking time and staircase competency,record the operation time,blood loss,incision length,hospitalization time.Results: All patients underwent surgery successfully.The follow-up time was 1-18 months(mean 4.4 months).postoperative FTA(5.9 + 0.9)compared with the preoperative FTA(20.7 + 7.2)was significantly better,the difference was statistically significant(P < 0.01);postoperative the first month ROM(131.4 + 7.9)compared with preoperative ROM(94.7 + 17.3)was significantly increased,the difference was statistically significant(P < 0.01);postoperative the first month HSS(85.3 + 1.8)compared with preoperative HSS(39.6 + 7.5)was significantly improved,the difference was statistically significant(P < 0.01);postoperative the first days and the second days,VAS(3.5 + 0.6),(2.7 + 0.5),pain was less.postoperative the start of the walk and climb stairs time were(24.2 + 2.2),(48.6 +3.2),quadriceps femoris early recovery.The operation time(148.9 + /-30.4)min,blood loss(+ 515.8 +)ml,postoperative incision were I/ a healing,incision length(10.4 + /-1.2)cm,hospitalization days(7.8 + 1.2)days.All the 19 patients were given adequate exposure during the operation.There were no complications,such as joint instability,prosthesis loosening,common peroneal nerve injury,infection and so on.Conclusions: subvastus quadriceps approach provides adequate exposure for TKA in valgus.The effect of lower limb force line correction,excellent early recovery,less pain and without increase in incidence of complications.