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Journal of Bone and Joint Surgery - British Volume, Vol 85-B, Issue 8, 1120-1122.
doi: 10.1302/0301-620X.85B8.14214  
Copyright © 2003 by British Editorial Society of Bone and Joint Surgery
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The extensile rectus snip exposure in revision of total knee arthroplasty

R. M. D. Meek, MBChB, MD, FRCS (Tr & Orth), Clinical and Research Fellow1; N. V. Greidanus, MD, MPh, FRCSC, Assistant Professor2; R. W. McGraw, MD, FRCSC, Emeritus Professor2; and B. A. Masri, MD, FRCSC, Associate Professor and Head of Adult Reconstruction Department2

1 Division of Lower Limb Reconstruction and Oncology, Department of Orthopaedics
2 Division of Adult Lower Limb Reconstruction and Oncology, Vancouver General Hospital, University of British Columbia, 910 West 10th Avenue, Suite 3114, Vancouver, V5Z 4E3, British Columbia, Canada.

Correspondence should be sent to Mr R. M. D. Meek at the Southern General Hospital, 1345 Govan Road, Glasgow G41 4TF, Scotland.

Revision of a total knee arthroplasty may require an extensile approach to permit a satisfactory exposure without compromising the attachment of the patellar tendon. It has been assumed that a rectus snip is a relatively benign form of release, but the effect of using this approach on function, pain and patient satisfaction is not known.

From January 1997 to December 1999, 107 patients who underwent revision of total knee arthroplasty were followed up at a minimum of two years (mean 40.5 months) and assessed by the Oxford Hip Score, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Short-Form (SF)-12 and patient satisfaction. Co-morbidity, surgical exposure, the Hospital for Special Surgery (HSS) knee scores and the range of movement were also used. A standard medial parapatellar approach was used in 57 patients and the rectus snip in 50. The two groups were equivalent for age, sex and co-morbidity scores. The WOMAC function, pain, stiffness and satisfaction scores demonstrated no statistical difference. The use of a rectus snip as an extensile procedure has no effect on outcome.






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Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General