Abstract
Introduction
Patient demand for a less invasive surgical approach reducing the trauma induced to the joint has resulted in the development of Minimally Invasive Surgery (MIS). Although the length of the surgical incision is appealing to patients, the changes are not purely cosmetic. The surgery should not violate the extensor mechanism in any way. Incisions into the quadriceps tendon or into the vastus medialis muscle make the approach less difficult but this violation will slow the recovery and affect the ROM of the knee. In Asian knees, authors found the variation of VMO, which is essential in early functional recovery in TKA patient, is so much, so new clinical test for MIS QS should be needed to show location relationship between the upper pole of the patella and the insertion of VMO itself to avoid unnecessary injury of VMO during TKA.
Purpose
The purpose of this comparison study was to verify whether MIS QS TKA can be a more functional and better method in treatment of advanced degenerative arthritis comparing with mini MIS TKA.
Methods
Group I: MIS QS group were 50 knees (69.3±9.7 years) and follow up period of that were 28.8± 0.4 months. Group II: mini quad split MIS TKA were 200 knees knees (67.4±5.6 years) and follow up period of that were 34.2± 0.6 months. We did clinical and radiological assessment.
Results
The length of incision of group I was 9.32±0.96 cm and that of group II was 10.9±0.5 cm. In clinical assessment, the postoperative pain score of group I was 47.5±2.74 points and that of group II was 47.4±3.27 points. The postoperative knee score of group I was 94.5±5.16 points and that of group II was 93.9±5.94 points. The postoperative knee functional score of group I was 90±8.94 points and that of group II was 93.4±6.73 points. The postoperative range of motion of group I was 122±16.9 degrees and that of group II was 116±23.5 degrees. In radiological assessment, The postoperative tibiofemoral angles of group I was 5±2.6 degrees and that of group II was 5.4±2.7 degrees. The α and β angle of group I was 95±3.5, 88±3.4 degrees and that of group II was 96±2.5, 89±2.4 degrees. The γ and δ angle of group I was 5.17±4.12, 85±1.4 degrees and that of group II was 3.96±3.1, 86±1.8 degrees.
Conclusions
There were no significant differences in functions between two groups. Both MIS QS and mini Quad split TKA are an effective and safe method in treatment of advanced degenerative arthritis.
