Abstract: Abstract:ObjectiveTo evaluate the feasibility and early clinical effect of miniinvasive total knee arthroplasty (TKA) via modified subvastus with minimal oblique cut (SMOC) approach for the treatment of moderatesevere osteoarthritis, and to compare with the TKA of conventional parapatellar approach.MethodsNinety moderatesevere osteoarthritis patients with more than 10° varus deformity of the knee were divided into SMOC group and parapatellar group randomly, 45 for SMOC approach and 45 for routine parapatellar approach respectively. Following items were recorded and analyzed: preoperative demographics, surgical time, length of incision, lateral retinaculum release rate, blood loss, Hb 2d after surgery, drainage volume, blood transfusion rate, recovery time of quadriceps strength, analgesia rate, VAS at 24h and 6 weeks, HSS score and ROM at 6d, 3 weeks, 6 weeks and 6 months after the surgery.ResultsAll the ninety patients were followed up for average 13 months (ranged from 9 to 19 months). There was no complication as infection, loose of prosthesis, deep venous thrombosis of lower limbs and healing problems of the incision occurred. Compare to parapatellar group, the incision was shorter, drainage volume and analgesia rate were less in SMOC group (P＜0.05). Similar operation time and blood loss demonstrated between the two groups (P>0.05). There was statistical difference in lateral retinaculum release rate, faster recovery of quadriceps strength, transfusion rate and Hb level 2d after surgery between parapatellar group and SMOC group, and those were dominant in SMOC group (P<0.01). Statistical differences existed between the two groups in terms of VAS score at 24h and 6 weeks(P<0.05), ROM and HSS score at 6d, 3 weeks and 6 weeks(P<0.05), while no differences were found in ROM and HSS score at 6 months after the surgery(P>0.05).ConclusionMiniinvasive TKA with modified SMOC approach would achieve effective outcomes for mediumsevere osteoarthritis without releasing the lateral patellar retinaculum, it demonstrated better rehabilitation effect than the traditional parapatellar approach.
李力, 董力军, 贾其余, 孔祥安. 两种不同手术入路行人工全膝关节置换术治疗中重度骨关节炎早期临床疗效观察#br#[J]. 中国现代手术学杂志, 2018, 22(4): 248-253.
LI Li, DONG Lijun, JIA Qiyu, KONG Xiangan. Early Clinical Effect of Miniinvasive Total Knee Arthroplasty via Modified SMOC Approach for Mediumsevere Osteoarthritis#br#. Chinese Journal of Modern Operative Surgery, 2018, 22(4): 248-253.
2018, Vol. 22 
