Wang Ying-Chun, Wu Sheng-Hua, Chen Chi-An, Liang Jing-Min, Yang Chia-Chi, Chen Chung-Hwan, Chung Wan-Rong, Chou Paul Pei-Hsi, Huang Hsuan-Ti
Ph.D. Program in Biomedical Engineering, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
J Clin Med. 2024 May 7;13(10):2736. doi: 10.3390/jcm13102736.
The comparison between the mini-midvastus (mini-MV) and mini-parapatellar (mini-MPP) approach in total knee arthroplasty (TKA) remains a subject of debate. The present study compared quadriceps activation, pain levels, and clinical outcomes between the two approaches; quadricep activation was assessed using surface electromyography (sEMG). This retrospective cross-sectional study comprised a total of 78 patients aged between 50 and 85 years with primary osteoarthritis. Patients were divided into a mini-MV (n = 38) group and a mini-MPP (n = 40) group according to the surgical approach. The two groups exhibited no significant differences in sEMG for the vastus medialis (VM) or rectus femoris (RF) at the follow-up time points, with the exception that the mini-MV group exhibited superior strength of RF during extensions at the 2-week follow-up. However, the mini-MPP group had superior Western Ontario and McMaster Universities Index (WOMAC) total and function scores at the 2- and 6-week follow-ups. The mini-MPP group also had superior WOMAC stiffness scores at the 2-week follow-up. The two groups did not differ significantly in terms of pain levels or morphine consumption. The sEMG data of quadriceps muscle would not differ significantly between the mini-MV and mini-MPP approaches for TKA. Moreover, the mini-MPP approach may yield superior WOMAC scores when compared with the mini-MV approach.
全膝关节置换术（TKA）中，小切口股中间肌入路（mini-MV）与小切口髌旁入路（mini-MPP）的比较仍是一个有争议的话题。本研究比较了两种入路的股四头肌激活情况、疼痛程度和临床结果；使用表面肌电图（sEMG）评估股四头肌激活情况。这项回顾性横断面研究共纳入了78例年龄在50至85岁之间的原发性骨关节炎患者。根据手术入路，患者被分为mini-MV组（n = 38）和mini-MPP组（n = 40）。在随访时间点，两组股内侧肌（VM）或股直肌（RF）的sEMG无显著差异，但在2周随访时，mini-MV组在伸展过程中RF的力量更强。然而，在2周和6周随访时，mini-MPP组的西安大略和麦克马斯特大学指数（WOMAC）总分及功能评分更高。在2周随访时，mini-MPP组的WOMAC僵硬评分也更高。两组在疼痛程度或吗啡消耗量方面无显著差异。TKA的mini-MV和mini-MPP入路之间，股四头肌的sEMG数据无显著差异。此外，与mini-MV入路相比，mini-MPP入路可能产生更高的WOMAC评分。
