Increased turn/amplitude parameters following subvastus approach in total knee arthroplasty

Abstract

To compare the improvement of the vastus medialis component of the quadriceps muscle electrophysiologically after the subvastus and medial parapatellar approaches in total knee arthroplasty (TKA). A total 26 patients that underwent primary unilateral in TKA were included into the study. TKAs were carried out via subvastus approach in 15 patients, while 11 patients were operated via medial parapatellar approach. The electrophysiological evaluations were carried out blindly with regard to the type of the surgical approach before the operation and at 6th week post-operatively. Non-surgical side was also evaluated as a control. Assessments were patellar tendon reflex analysis, motor unit potential analysis and interference pattern analysis (IPA) including turn-amplitude analysis and IPA during maximum contraction. When they were compared to the pre-operative values, "the total mean amplitude" and "the mean turn/sec" parameters were significantly increased in group of subvastus approach (p = 0.017 and p = 0.009, respectively) at the post-operative 6th week. We would not be able to find any difference regarding the other electrophysiological parameters. There was also no significant difference between groups. If there was no significant difference in all the electrophysiological parameters, the increase in turn-amplitude analysis in the group of subvastus approach would be considered as an indicator of a faster functional improvement of knee extensor mechanism in these cases.