Muscle damage during minimally invasive surgical total knee arthroplasty traditional versus optimized subvastus approach

The Knee
Roberto RossiFilippo Castoldi

Abstract

Decreased muscle damage is reported as an advantage of minimally invasive surgical (MIS) approaches in total knee arthroplasty (TKA). The purpose of this study was to evaluate the anatomy of vastus medialis obliquus (VMO) tendon at its patellar insertion as well as to determine the amount and location of muscle damage comparing traditional subvastus approach and optimized subvastus approach. TKAs were performed in ten human cadavers (20 knees). In each specimen, one knee underwent the traditional subvastus approach and the contralateral knee the optimized subvastus approach. The risk of tearing and damaging the VMO muscle during the traditional subvastus approach is significantly higher (70% of the cases) compared to the optimized technique (30%). The amount of damage to the VMO muscle using the traditional subvastus approach was: 80% of the muscle's width in two cases, 60% in three cases, and 30% in two. The damage created by the optimized subvastus approach occurred along the edge of the tendon and the first fibers of the VMO muscle close to the muscle-tendon junction (less than 20% of muscle's width). Clinical studies are needed to determine the functional implications of these findings.

References

Jan 1, 1993·European Journal of Vascular Surgery·R L InsallJ Chamberlain
Jan 1, 1997·The Australian Journal of Physiotherapy·Mili NozicDarryl de Klerk
Mar 7, 2002·Archives of Orthopaedic and Trauma Surgery·Erdal CilaAkif Oztürk
Jul 8, 2005·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Elias PanagiotopoulosGiles Scuderi
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Nov 1, 2006·The Journal of Bone and Joint Surgery. British Volume·A F ChenA J Tria
Jan 16, 2008·International Orthopaedics·Young Bok JungChang Hyun Nam

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Citations

Mar 16, 2019·Knee Surgery & Related Research·Myoung-Soo ChaYoung-Jin Seo
Oct 9, 2016·Annals of Biomedical Engineering·Kyle S MartinShayn M Peirce
Jul 19, 2012·Clinical Orthopaedics and Related Research·Julien WegrzynMark W Pagnano

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