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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 5, 584-591.
doi: 10.1302/0301-620X.90B5.20122  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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Total knee replacement performed with either a mini-midvastus or a standard approach

A PROSPECTIVE RANDOMISED CLINICAL AND RADIOLOGICAL TRIAL

Th. Karachalios, MD, DSc, Associate Professor1; D. Giotikas, MD, Resident1; N. Roidis, MD, Consultant Orthopaedic Surgeon1; L. Poultsides, MD, Resident1; K. Bargiotas, MD, Consultant Orthopaedic Surgeon1; and K. N. Malizos, MD, Professor and Chairman1

1 Orthopaedic Department School of Medicine, Faculty of Health Sciences, University of Thessaly, 22 Papakyriazi Street, Larissa 41222, Greece.

Correspondence should be sent to Dr Th. Karachalios; e-mail: kar{at}med.uth.gr

We report the clinical and radiological results of a two- to three-year prospective randomised study which was designed to compare a minimally-invasive technique with a standard technique in total knee replacement and was undertaken between January 2004 and May 2007. The mini-midvastus approach was used on 50 patients (group A) and a standard approach on 50 patients (group B). The mean follow-up in both groups was 23 months (24 to 35).

The functional outcome was better in group A up to nine months after operation, as shown by statistically significant differences in the mean function score, mean total score and the mean Oxford knee score (all, p = 0.05). Patients in group A had statistically significant greater early flexion (p = 0.04) and reached their greatest mean knee flexion of 126.5° (95° to 135°) 21 days after operation. However, at final follow-up there was no significant difference in the mean maximum flexion between the groups (p = 0.08). Technical errors were identified in six patients from group A (12%) on radiological evaluation.

Based on these results, the authors currently use minimally-invasive techniques in total knee replacement in selected cases only.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General