Abstract
BackgroundThirty thousand knee replacements are performed annually in the UK. There is uncertainty as to the best surgical approach to the knee joint for knee arthroplasty. We planned a randomised controlled trial to compare a standard medial parapatellar arthrotomy with sub-vastus arthrotomy for patients undergoing primary total knee arthroplasty in terms of short and long term knee function.MethodsPatients undergoing primary total knee arthroplasty at the local NHS Trust are to be recruited into the study. Patients are to be randomised into either the subvastus or medial parapatellar approache to knee arthroplasty. The primary outcome measures will be the American Knee Society and WOMAC Scores. The secondary outcome measures will be patient based measures of EuroQol and SF-36. All outcomes will be measured pre-operatively, 1, 6, 12 and 52 weeks post-operatively. We will also review pain intensity using a pain and analgesia diary. Ease of surgical exposure and complications will also be analysed.DiscussionEvidence is lacking concerning the best surgical approach to the knee joint for patients undergoing primary total knee replacement. This pragmatic randomised trial tests the hypothesis that the sub-vastus approach is significantly superior to the standard medial parapatellar approach in terms of short and long term knee function.
Highlights
Thirty thousand knee replacements are performed annually in the UK
This trial proposes to: 1. study the effectiveness and efficiency at 1, 6, 12 and 52 weeks of a standard medial parapatellar arthrotomy compared with a sub-vastus arthrotomy in primary total knee replacement
2. examine both clinical and economic outcomes of care of a standard medial parapatellar arthrotomy compared with a sub-vastus arthrotomy in primary total knee replacement at 1, 6,12 and 52 weeks
Summary
There is uncertainty as to the best surgical approach to the knee joint for knee arthroplasty. We planned a randomised controlled trial to compare a standard medial parapatellar arthrotomy with sub-vastus arthrotomy for patients undergoing primary total knee arthroplasty in terms of short and long term knee function. The approach maintains the medial parapatellar blood supply and preserves the extensor mechanism [4,5,6]. Theoretically, it decreases the likelihood of patellar subluxation, fracture, or patellar avascular necrosis (reported as having an incidence of 17%, 21% and 10% respectively) [7,8]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
