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Quadriceps-sparing technique comparable to medial parapatellar arthrotomy in TKA
Patients who underwent primary total knee arthroplasty with the quadriceps-sparing subvastus technique experienced no significant early functional advantages or differences in opioid utilization compared with the medial parapatellar arthrotomy technique, according to study results.
In the prospective, double-blind study, researchers randomly assigned 129 patients undergoing TKA to receive the quadriceps-sparing (QS) subvastus or medial parapatellar arthrotomy (MPPA) technique after skin incision. Minimally invasive surgery principles and standardized anesthesia, implants, analgesia and rehabilitation were used for all surgical procedures.
The researchers obtained the Knee Society score at baseline and at 1 and 3 months after surgery. Through weekly telephone interviews, the researchers also collected patient-reported outcomes, including ambulatory device use, the University of California Los Angeles activity score, performance of daily living activities and opioid utilization.
The researchers found no differences between groups in opioid utilization, either during the acute hospitalization or during the 8 weeks after surgery. Patients who underwent QS experienced significantly less pain at rest on postoperative day 1 and with activity on day 3.
Knee Society scores improved significantly in both groups at 1 month and 3 months compared with baseline. Additionally, week-to-week gains in walking independence through 5 weeks after surgery improved significantly compared with baseline, according to the researchers.
Both groups also experienced a lag in independence from ambulatory devices outside the home vs. independence indoors by about 2 weeks.
Disclosure: Kantor is a consultant for DePuy Orthopaedics.