The vastus medialis muscle-splitting approach: a technique for total knee arthroplasty

The Knee ◽  
1998 ◽  
Vol 5 (3) ◽  
pp. 183-186 ◽  
Author(s):  
James M Schneider ◽  
James V Bono ◽  
Franklin Glockner ◽  
Joel Melnikoff ◽  
Frederick Fletcher
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Vastus Medialis ◽  
Vastus Medialis Muscle ◽  
Total Knee

Modified Intervastus Approach to the Knee

2017 ◽  
Vol 31 (05) ◽  
pp. 422-424
Author(s):  
James Kohlman ◽  
Craig Valle ◽  
Muthana Sartawi
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Extension ◽  
Extensor Mechanism ◽  
Vastus Medialis ◽  
Medial Parapatellar Approach ◽  
Total Knee ◽  
Anterior Knee ◽  
Medial Parapatellar

AbstractThe modified intervastus approach to the anterior knee is an approach that may be used in the majority of patients undergoing total knee arthroplasty. This article presents the first description of this approach. The advantages of this approach include its extensile nature, similar to a medial parapatellar approach, and preservation of the extensor mechanism and the vastus medialis, leading to a more rapid return to active knee extension than is traditionally observed. The approach is also simple to perform, easy to close, and is compatible with more extensile approaches such as a quadriceps snip if required in revision scenarios.

Variation of the Vastus Medialis Obliquus Insertion and its Relevance to Minimally Invasive Total Knee Arthroplasty

2008 ◽  
Vol 23 (4) ◽  
pp. 600-604 ◽  
Author(s):  
Graeme Holt ◽  
Tom Nunn ◽  
Ruth A. Allen ◽  
Alastair W. Forrester ◽  
Alberto Gregori
Keyword(s):  
Total Knee Arthroplasty ◽  
Minimally Invasive ◽  
Knee Arthroplasty ◽  
Vastus Medialis ◽  
Vastus Medialis Obliquus ◽  
Total Knee

scholarly journals Potential Instability and Malfunction of Knee Joints with Vastus Medialis Impairment after Total Knee Arthroplasty

2021 ◽  
Vol 11 (6) ◽  
pp. 2764
Author(s):  
Yongkyung Lee ◽  
Hai-Mi Yang ◽  
Jinju Jang ◽  
Dai-Soon Kwak ◽  
Jungsung Kim ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Muscle Force ◽  
Knee Joints ◽  
Force Distribution ◽  
Vastus Medialis ◽  
Reaction Forces ◽  
Total Knee ◽  
Joint Reaction ◽  
Total Test

Four pairs of fresh-frozen cadaver knees (eight knees, four male knees) with a mean age of 72 ± 7 years were used for tests involving a customized simulator capable of controlling quadriceps loading conditions. The muscle force distribution of the quadriceps for the normal loading condition was applied on the basis of muscle cross-sectional area data, as previously reported (VM: 31 N; RF/VI: 49 N; VL: 45 N). To simulate vastus medialis (VM) impairment, we set the muscle force for VM in the muscle force distribution of the quadriceps at zero (VM: 0 N; RF/VI: 49 N; VL: 45 N). The joint reaction forces and moments on knee joints that underwent total knee arthroplasty (TKA) did not differ significantly according to VM impairment status for all flexion angles (p > 0.05). Nevertheless, the vectors of internal–external moments mostly showed a tendency for alteration from external to internal due to VM impairment. This tendency was evident in 9 cases in 12 total test pairs (with and without VM impairment). Furthermore, the vectors of the anterior–posterior reaction forces mostly showed a tendency to increase anteriorly due to VM impairment. This tendency was also evident in 9 cases in 12 total test pairs (with and without VM impairment). These results indicate that posterior dislocation of the tibia may be induced if VM impairment occurs after TKA. In conclusion, VM impairment in knee joints undergoing TKA may contribute to posterior dislocation of the tibia by a paradoxical roll-back with enhancements of the anterior joint reaction force and external moment during knee-joint flexion. Our findings may be valuable for understanding the mechanism of potential instability and malfunction due to VM impairment in knee joints after TKA, and may help to optimize clinical/rehabilitation training plans to improve the prognosis (stability and function) of knee joints undergoing TKA.

scholarly journals Retrospective study of relationship between vastus medialis volume on SPECT-CT and outcome of unilateral total knee arthroplasty

Medicine ◽  
2021 ◽  
Vol 100 (1) ◽  
pp. e24138
Author(s):  
Hyeong Jik Kim ◽  
Hyung Jun Park ◽  
Jong Byung Oh ◽  
Moon Jong Chang ◽  
Seung-Baik Kang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Retrospective Study ◽  
Knee Arthroplasty ◽  
Vastus Medialis ◽  
Total Knee

Trends in Periprosthetic Knee Infection and Associated Costs: A Population-Based Study Using National Data

2020 ◽  
Author(s):  
Robert Brochin ◽  
Jashvant Poeran ◽  
Khushdeep S. Vig ◽  
Aakash Keswani ◽  
Nicole Zubizarreta ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Length Of Stay ◽  
Knee Arthroplasty ◽  
Trend Test ◽  
Strong Impact ◽  
Hospitalization Costs ◽  
Teaching Status ◽  
Increasing Trend ◽  
Total Knee ◽  
Increasing Trends

AbstractGiven increasing demand for primary knee arthroplasties, revision surgery is also expected to increase, with periprosthetic joint infection (PJI) a main driver of costs. Recent data on national trends is lacking. We aimed to assess trends in PJI in total knee arthroplasty revisions and hospitalization costs. From the National Inpatient Sample (2003–2016), we extracted data on total knee arthroplasty revisions (n = 782,449). We assessed trends in PJI prevalence and (inflation-adjusted) hospitalization costs (total as well as per-day costs) for all revisions and stratified by hospital teaching status (rural/urban by teaching status), hospital bed size (≤299, 300–499, and ≥500 beds), and hospital region (Northeast, Midwest, South, and West). The Cochran–Armitage trend test (PJI prevalence) and linear regression determined significance of trends. PJI prevalence overall was 25.5% (n = 199,818) with a minor increasing trend: 25.3% (n = 7,828) in 2003 to 28.9% (n = 19,275) in 2016; p < 0.0001. Median total hospitalization costs for PJI decreased slightly ($23,247 in 2003–$20,273 in 2016; p < 0.0001) while median per-day costs slightly increased ($3,452 in 2003–$3,727 in 2016; p < 0.0001), likely as a function of decreasing length of stay. With small differences between hospitals, the lowest and highest PJI prevalences were seen in small (≤299 beds; 22.9%) and urban teaching hospitals (27.3%), respectively. In stratification analyses, an increasing trend in PJI prevalence was particularly seen in larger (≥500 beds) hospitals (24.4% in 2003–30.7% in 2016; p < 0.0001), while a decreasing trend was seen in small-sized hospitals. Overall, PJI in knee arthroplasty revisions appears to be slightly increasing. Moreover, increasing trends in large hospitals and decreasing trends in small-sized hospitals suggest a shift in patients from small to large volume hospitals. Decreasing trends in total costs, alongside increasing trends in per-day costs, suggest a strong impact of length of stay trends and a more efficient approach to PJI over the years (in terms of shorter length of stay).

Effect of Manipulation under Anesthesia of the First Knee in Staged Bilateral Total Knee Arthroplasty on Clinical Outcome and Satisfaction

2020 ◽  
Author(s):  
Jung-Won Lim ◽  
Yong-Beom Park ◽  
Dong-Hoon Lee ◽  
Han-Jun Lee
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Functional Score ◽  
Manipulation Under Anesthesia ◽  
Total Knee

AbstractThis study aimed to evaluate whether manipulation under anesthesia (MUA) affect clinical outcome including range of motion (ROM) and patient satisfaction after total knee arthroplasty (TKA). It is hypothesized that MUA improves clinical outcomes and patient satisfaction after primary TKA. This retrospective study analyzed 97 patients who underwent staged bilateral primary TKA. MUA of knee flexion more than 120 degrees was performed a week after index surgery just before operation of the opposite site. The first knees with MUA were classified as the MUA group and the second knees without MUA as the control group. ROM, Knee Society Knee Score, Knee Society Functional Score, Western Ontario and McMaster Universities (WOMAC) score, and patient satisfaction were assessed. Postoperative flexion was significantly greater in the MUA group during 6 months follow-up (6 weeks: 111.6 vs. 99.8 degrees, p < 0.001; 3 months: 115.9 vs. 110.2 degrees, p = 0.001; 6 months: 120.2 vs. 117.0 degrees, p = 0.019). Clinical outcomes also showed similar results with knee flexion during 2 years follow-up. Patient satisfaction was significantly high in the MUA group during 12 months (3 months: 80.2 vs. 71.5, p < 0.001; 6 months: 85.8 vs. 79.8, p < 0.001; 12 months: 86.1 vs. 83.9, p < 0.001; 24 months: 86.6 vs. 85.5, p = 0.013). MUA yielded improvement of clinical outcomes including ROM, and patient satisfaction, especially in the early period after TKA. MUA in the first knee could be taken into account to obtain early recovery and to improve patient satisfaction in staged bilateral TKA.

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