Comparative Study Of The Early Clinical Effects Of Minimally Invasive Total Knee Arthroplasty With Medial Submuscular Approach And Limited Condylar Approach

Objectives To evaluate and compare the early clinical results between mini-subvastus approach and mini-medial parapatellar approach for minimally invasive total knee arthroplasty.Methods Ninety patients with primary total hip arthroplasty were recruited and randomly divided two groups in this study,forty-four patients in vastus medialis group with mini-subvastus approach for total knee arthroplasty,another forty-six patients in parapatellar group with mini-medial parapatellar approach for total knee arthroplasty.Two approaches were estimated according to recording and comparing the patient's general information,preoperative hemoglobin,preoperative knee joint range of motion,preoperative VAS scales,preoperative HSS scores,lateral retinacular release rate,operation time,operative incision length,interoperative blood loss,postoperat ive two days hemoglobin,postoperative drainage,postoperative transfusion rate,postoperative 24 hours and 6 weeks VAS scales,muscle strength recover time for quadriceps,and postoperative 6 days,3 weeks,6 weeks,3 months,6 months HSS scores and knee joint range of motion.ResultsNinety patient's total knee arthroplasty were smoothly completed.The average follow up period was eight months(range from six months to twelve months).There was no statistical significant difference between template group and traditional group in terms of the patient's general information,preoperative hemoglobin,preoperative knee joint range of motion,preoperative VAS scales,preoperative HSS scores,postoperative two days hemoglobin,postoperative drainage.Comparing with parapatellar group,vastus medialis group was less in terms of lateral retinacular release rate,postoperative 24 hours scales and muscle strength recover time for quadriceps.Vastus medialis group was longer than parapatellar group in aspects of operative incision length,operation time and interoperative blood loss.There was no statistical significant difference between two groups in terms of HSS scores and knee joint range of motion in the followed-up period expect for postoperative 6 days.Conclusion Both mini-subvastus approach and mini-medial parapatellar approach can successfully accomplish minimally invasive total hip arthroplasty,and represent favorable early clinical outcome.Mini-subvastus approach do not damage the instrument of extension o f the knee,and need not release the lateral retinaculum,which is superior to mini-medial parapatellar approach.