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BMC Musculoskeletal Disorders

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Open Access 01-12-2019 | Research article

Quadriceps-sparing versus traditional medial parapatellar approaches for total knee arthroplasty: a meta-analysis

Authors: Fu-Zhen Yuan, Ji-Ying Zhang, Dong Jiang, Jia-Kuo Yu

Published in: BMC Musculoskeletal Disorders | Issue 1/2019

Abstract

Background

There is still controversy regarding whether Quadriceps-sparing (QS) approach for total knee arthroplasty (TKA) lead to better earlier recovery as well as compromising low limb alignment and prosthesis position compared with conventional medial parapatellar (MP) approach. To overcome the shortcomings and inaccuracies of single studies, the clinical outcomes and radiographic assessments of QS approach and MP approach were evaluated through meta-analysis.

Methods

We performed this meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. A literature search was conducted in the PubMed, EMBase, Cochrane Collaboration Library and Web of Science databases. Our search strategy followed the requirements of the Cochrane Library Handbook. The study selection, data extraction and assessment of methodological quality were independently completed by four authors. And subgroup analysis and publication bias were also performed in the study.

Results

Eight prospective randomized controlled trials (RCTs) and eight retrospective studies were identified. Overall meta-analysis and subgroup meta-analysis of RCTs identified the QS approach mainly was associated with increased Knee Society function score beyond 24 months postoperatively (weighted mean difference [WMD] 1.78, P = 0.0004) (WMD 1.86, P = 0.0002), and improved range of motion 1–2 weeks postoperatively (WMD 5.84, P < 0.00001) (WMD 4.87, P = 0.002). Besides, lower visual analogue scale on postoperative day 1 (WMD -0.91, P = 0.02), shorter hospital stay (WMD -0.88, P = 0.02) and shorter incision (extension) (WMD -4.62, P < 0.00001) were indicated in overall meta-analysis. However, surgical and tourniquet time was significantly longer in QS group by both overall and subgroup meta-analysis.

Conclusions

QS approach may accelerate early recovery without increasing the risk of malalignment of low limb and malposition of prosthesis.

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Title: Quadriceps-sparing versus traditional medial parapatellar approaches for total knee arthroplasty: a meta-analysis
Authors: Fu-Zhen Yuan
Ji-Ying Zhang
Dong Jiang
Jia-Kuo Yu
Publication date: 01-12-2019
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2019
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-019-2482-7

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Quadriceps-sparing versus traditional medial parapatellar approaches for total knee arthroplasty: a meta-analysis

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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