Favorable Isokinetic Hamstring/Quadriceps Ratio Following Midvastus Approach as Compared to Median Parapatellar Approach in Primary Total Knee Arthroplasty

Purpose: Surgical approach is a major determinant for functional recovery after joint replacement surgery. This study compares the functional recovery in patients receiving primary total knee arthroplasty using two common surgical approaches, the Median Parapatellar (MP) and the Midvastus (MV). Methods: A total of seventy-three patients having total knee arthroplasty by MV and MP approaches were prospectively studied to evaluate differences in hamstring and quadriceps torques at 60 and 180 degrees, preoperatively, and 12 weeks postoperatively, using Cybex dynamometer. Results: There was no difference in the range of motion at 6 and 12 weeks postoperatively as compared to the preoperative levels. Although the peak muscular torques at the angular velocity of 60°/sec and 180°/sec showed some improvement in both groups of patients, the improvement was not statistically significant. However, more patients in the MP group with normal H/Q ratio preoperatively had abnormal H/Q ratio postoperatively when tested at the angular velocity of 60°/sec. (Chi-square, p = 0.024) In contrast, more patients with abnormal H/Q ratio preoperatively in the MV group had normal H/Q ratio postoperatively when tested at the angular velocity of 60°/sec. (Chi-square, p =0.008) Conclusions: In summary, the MV approach is favorable to the MP approach in terms of the short-term recovery of muscle functions.

並列關鍵字

total knee arthroplasty ； approaches ； isokinetic study ； H/Q ratio

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