Department of Orthopaedics and Traumatology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Cerrahpaşa Tıp Fakültesi Yerleşkesi Kocamustafapaşa Caddesi No:53 Cerrahpaşa , Fatih, İstanbul, 34098, Turkey.
Department of Orthopaedics and Traumatology, Beykoz State Hospital, Saip Molla Cad. Kısayol Sok. No:1, Beykoz, İstanbul, Turkey.
Arch Orthop Trauma Surg. 2024 Nov;144(11):4839-4847. doi: 10.1007/s00402-024-05570-5. Epub 2024 Sep 23.
In primary total knee arthroplasty (TKA) surgeries, the medial parapatellar (MP) and subvastus (SV) approaches are frequently employed. The SV approach involves preserving the vastus medialis muscle, leading to debates about the possibility of earlier healing of the extensor mechanism. Shear wave elastography (SWE) is known for monitoring tissue healing. In this study, our research question revolves around whether there exist differences in tissue healing following MP and SV approaches. Unlike previous studies, we aim to investigate this difference using solely SWE, which provides a quantitative measurement specifically targeting the vastus medialis muscle.
We divided 17 patients into two groups: SV (10 patients) and MP (7 patients). SWE measurements and clinical scores were recorded before surgery and at the 3rd-month follow-up. The first straight leg raising days were also recorded.
Both the MP and SV groups showed significant improvement in clinical scores postoperatively. Straight leg raising time was comparatively earlier in the SV group, but no significant difference was found. SWE measurements revealed similar recovery values in the vastus medialis muscle between the two groups.
Both MP and SV approaches demonstrate similar and favorable early outcomes in TKA surgery. The preservation of the vastus medialis in the SV approach does not lead to significant differences in clinical scores or muscle recovery compared to the MP approach.
The study was retrospectively registered on ClinicalTrials.gov on March 7, 2024 (NCT06297746). https://classic.
gov/ct2/show/NCT06297746?id=am7mi3VB&draw=2&rank=1 .
在初次全膝关节置换术（TKA）手术中，常采用内侧髌旁（MP）和髌下入路（SV）。SV 入路保留股四头肌内侧头，导致关于伸肌机制愈合更早的可能性的争论。剪切波弹性成像（SWE）以监测组织愈合而闻名。在这项研究中，我们的研究问题是围绕 MP 和 SV 入路后组织愈合是否存在差异。与之前的研究不同，我们旨在仅使用 SWE 来研究这种差异，SWE 提供了一种针对股四头肌内侧头的定量测量。
我们将 17 名患者分为两组：SV（10 名患者）和 MP（7 名患者）。在术前和术后 3 个月随访时记录 SWE 测量值和临床评分。还记录了首次直腿抬高的天数。
MP 和 SV 组术后临床评分均显著改善。SV 组直腿抬高时间较早，但无显著差异。SWE 测量显示两组股四头肌内侧头的恢复值相似。
MP 和 SV 入路在 TKA 手术中均表现出相似的早期良好结果。SV 入路保留股四头肌内侧头与 MP 入路相比，在临床评分或肌肉恢复方面没有显著差异。
该研究于 2024 年 3 月 7 日在 ClinicalTrials.gov 上进行了回顾性注册（NCT06297746）。https://classic.clinicaltrials.gov/ct2/show/NCT06297746?id=am7mi3VB&draw=2&rank=1。
NCT06297746。
