Health Condition 1: M179- Osteoarthritis of knee, unspecified
Conditions
Interventions
Intervention1: Subvastus approach (SVA): The subvastus approach developed to avoid drawbacks of medial parapatellar approach. The theoretical advantages of this approach
are: 1) preservation of an int
2) better postoperative quadriceps control and strength
3) decreased postoperative pain
4)
decreased quadriceps scarring
5) preservation of patellar vascularity
6) improved
patellar tracking and stability
7) diminished need for lateral release
8) decreased blood loss
9) quicker rehabilitation
and 10) shorter hospital stays.
Potential disadvantages compared with the standard median parapatellar approach
include: 1) reduced overall exposure to the joint with an increased incidence of
implant
2) increased risk of damaging the neurovascular
structures
3) subvastus hematoma
4) damage related to over-stretching and
ischemia that may occur within the vastus medialis.
Intervention2: Midvastus approach
(MVA): Midvastus approach
(MVA) disrupts less of the extensor mechanism a
Sponsors
Dr Rajendra D Jangle
Eligibility
Inclusion criteria
Inclusion criteria: 1. Patients with advanced arthritis of knee who are willing for total knee arthroplasty 2. Patients with less than 15-degree varus, 20-degree valgus, or 10-degree flexion contracture, with a minimum of 90-degree range of motion
Exclusion criteria
Exclusion criteria: 1. Patients with more than 15-degree varus, 20-degree valgus, or 10-degree flexion contracture, with less than of 90-degree range of motion 2. Patients with old scars over incision site requiring modification of approach 3. Patients not consenting for study protocol.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Knee Society ScoreTimepoint: pre-operatively (baseline), post-operatively on day 3, on discharge, 6 weeks, 6 months and 12 month | — |
Secondary
| Measure | Time frame |
|---|---|
| Blood lossTimepoint: Intra- operative, on discharge;days to SLRTimepoint: post-operatively on day 3, on discharge, 6 weeks, 6 months and 12 month;Incidence and type of complicationTimepoint: Intra- operative, post-operatively on day 3, on discharge, 6 weeks, 6 months and 12 month;knee flexion and extension range of motion (ROM, degrees)Timepoint: pre-operatively (baseline), Intra- operative, post-operatively on day 3, on discharge, 6 weeks, 6 months and 12 month;Length of post-operative stay in the orthopaedic ward (days)Timepoint: on discharge;operation duration (minutes)Timepoint: Intra- operative;pain (Numerical Assessment Scale [VAS, 1-10])Timepoint: pre-operatively (baseline), post-operatively on day 3, on discharge, 6 weeks, 6 months and 12 month;quadriceps lag on SLR (degrees)Timepoint: pre-operatively (baseline), post-operatively on day 3, on discharge, 6 weeks, 6 months and 12 month;Radiological outcomeTimepoint: on discharge;surgeonâ??s perceived level of difficulty with the operative approach (Numerical Assessment Scale [NAS, 1-10] include complete exposure of tibial plateau and both femur condyles, patella eversion/ subluxation, lateral retinacular release/ patella tracking and tourniquet duration)Timepoint: Intra- operative;thigh girth in c.m.Timepoint: pre-operatively (baseline), post-operatively on day 3, on discharge, 6 weeks, 6 months and 12 month | — |
Countries
India
Contacts
Public ContactDr Rajendra D Jangle
Sancheti Institute of Orthopedics and Rehabilitation
Outcome results
None listed