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Effect of the surgical exposure on the early postoperative period after total knee arthroplasty
Orv Hetil. 2020 07; 161(29):1208-1214.OH

Abstract

INTRODUCTION

Total knee arthroplasty has become one of the most successful and safest surgical procedures in orthopedic surgery. Of the many different types of surgical exposure, the most common, so-called medial parapatellar (MP) incision is the cut of the quadriceps tendon, which impairs extensor function. In contrast, subvastus (S) exposure, which spares the extensor apparatus, may promise better healing.

AIM

The purpose of our prospective observational study at the Orthopedic Clinic of Semmelweis University is to compare the effects of the MP and the S excision on the early postoperative period.

METHOD

The 60 patients enrolled were randomly assigned to two different groups according to the type of intervention. In the study, we measured the effects of the two different methods of surgical exposure on homogeneous patient groups in the early postoperative period based on international literature and the parameters we defined.

RESULTS

Visual analog scale (VAS) measured resting and active pain levels for the first 10 days, suggesting a more pronounced difference in active VAS values for the S group. In the case of active VAS, patients in the S group also had significantly less pain on days 2, 3, and 10 than in the MP group. Taking into account the results of the other days, it is in favour of preserving the integrity of the extensor apparatus for improved postoperative functionality. Patients' knee joint range of motion was also measured. On day 1, those in the S group were significantly larger. As the days progress, MP group members catch up with S group during their rehabilitation. Group S patients had an average of 1.944 days to extended leg elevation, which is nearly two days shorter compared to the MP group (p<0.0001).

CONCLUSIONS

After statistical analysis of data, subvastus exposure appears to be more beneficial in the rehabilitation of the early postoperative period. However, large-scale, multicentre observational studies are required to establish evidence. Orv Hetil. 2020; 161(29): 1208-1214.

Authors+Show Affiliations

Általános Orvostudományi Kar, Ortopédiai Klinika,Semmelweis Egyetem, Budapest, Üllői út 78/b, 1082.Általános Orvostudományi Kar, Ortopédiai Klinika,Semmelweis Egyetem, Budapest, Üllői út 78/b, 1082.Általános Orvostudományi Kar, Ortopédiai Klinika,Semmelweis Egyetem, Budapest, Üllői út 78/b, 1082.Általános Orvostudományi Kar, Ortopédiai Klinika,Semmelweis Egyetem, Budapest, Üllői út 78/b, 1082.Általános Orvostudományi Kar, Ortopédiai Klinika,Semmelweis Egyetem, Budapest, Üllői út 78/b, 1082.

Pub Type(s)

Journal Article
Observational Study

Language

hun

PubMed ID

32628620

Citation

Bejek, Zoltán, et al. "Effect of the Surgical Exposure On the Early Postoperative Period After Total Knee Arthroplasty." Orvosi Hetilap, vol. 161, no. 29, 2020, pp. 1208-1214.
Bejek Z, Holnapy G, Skaliczki G, et al. Effect of the surgical exposure on the early postoperative period after total knee arthroplasty. Orv Hetil. 2020;161(29):1208-1214.
Bejek, Z., Holnapy, G., Skaliczki, G., Stubnya, B., & Szatmári, A. (2020). Effect of the surgical exposure on the early postoperative period after total knee arthroplasty. Orvosi Hetilap, 161(29), 1208-1214. https://doi.org/10.1556/650.2020.31774
Bejek Z, et al. Effect of the Surgical Exposure On the Early Postoperative Period After Total Knee Arthroplasty. Orv Hetil. 2020;161(29):1208-1214. PubMed PMID: 32628620.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of the surgical exposure on the early postoperative period after total knee arthroplasty AU - Bejek,Zoltán, AU - Holnapy,Gergely, AU - Skaliczki,Gábor, AU - Stubnya,Bence, AU - Szatmári,Attila, PY - 2020/03/03/received PY - 2020/04/07/accepted PY - 2020/7/7/entrez PY - 2020/7/7/pubmed PY - 2020/7/14/medline KW - knee surgery KW - medial parapatellar KW - medialis parapatellaris KW - subvastus KW - teljes felszínpótló endoprotetika KW - total knee arthroplasty KW - térdsebészet SP - 1208 EP - 1214 JF - Orvosi hetilap JO - Orv Hetil VL - 161 IS - 29 N2 - INTRODUCTION: Total knee arthroplasty has become one of the most successful and safest surgical procedures in orthopedic surgery. Of the many different types of surgical exposure, the most common, so-called medial parapatellar (MP) incision is the cut of the quadriceps tendon, which impairs extensor function. In contrast, subvastus (S) exposure, which spares the extensor apparatus, may promise better healing. AIM: The purpose of our prospective observational study at the Orthopedic Clinic of Semmelweis University is to compare the effects of the MP and the S excision on the early postoperative period. METHOD: The 60 patients enrolled were randomly assigned to two different groups according to the type of intervention. In the study, we measured the effects of the two different methods of surgical exposure on homogeneous patient groups in the early postoperative period based on international literature and the parameters we defined. RESULTS: Visual analog scale (VAS) measured resting and active pain levels for the first 10 days, suggesting a more pronounced difference in active VAS values for the S group. In the case of active VAS, patients in the S group also had significantly less pain on days 2, 3, and 10 than in the MP group. Taking into account the results of the other days, it is in favour of preserving the integrity of the extensor apparatus for improved postoperative functionality. Patients' knee joint range of motion was also measured. On day 1, those in the S group were significantly larger. As the days progress, MP group members catch up with S group during their rehabilitation. Group S patients had an average of 1.944 days to extended leg elevation, which is nearly two days shorter compared to the MP group (p<0.0001). CONCLUSIONS: After statistical analysis of data, subvastus exposure appears to be more beneficial in the rehabilitation of the early postoperative period. However, large-scale, multicentre observational studies are required to establish evidence. Orv Hetil. 2020; 161(29): 1208-1214. SN - 1788-6120 UR - https://www.unboundmedicine.com/medline/citation/32628620/A_feltárás_módjának_hatása_a_közvetlen_posztoperatív_időszakra_teljes_felszínpótló_térdprotézis_beültetése_esetén L2 - https://akjournals.com/doi/10.1556/650.2020.31774 DB - PRIME DP - Unbound Medicine ER -