Minimally Invasive (Epivastus) Approach for Total Knee Arthroplasty.

IF 1.1 Q4 MEDICINE, RESEARCH & EXPERIMENTAL
Sovremennye Tehnologii v Medicine Pub Date : 2023-01-01 Epub Date: 2023-07-28 DOI:10.17691/stm2023.15.4.02
S E Sokolovskii, A A Zykin, N N Rukina, E E Malyshev
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引用次数: 0

Abstract

The aim of the study was to assess the efficiency of a developed minimally invasive (epivastus) approach in total knee arthroplasty (TKA) by comparing its early results with those of a standard medial mediapatellar approach (MMPA).

Materials and methods: A single-center, comparative randomized prospective study involved 127 patients, who underwent TKA using MMPA (n=62) and a modified minimally invasive epivastus approach (n=65) within the period from January to December, 2022. The study groups were comparable by gender, age, BMI, gonarthrosis stage, and knee joint functioning parameters.

Results: The surgery duration in the epivastus group was significantly lower compared to MMPA group (p<0.001). However, the interpretation of tissue trauma markers assessment appeared rather ambiguous. There were no statistically significant differences in lactate dehydrogenase (p=0.253). C-reactive protein, myoglobin, creatinine showed a significant increase in MMPA group (p<0.001; p=0.002 and p=0.048, respectively), while aspartate aminotransferase, creatine phosphokinase and ESR, in contrast, increased in the epivastus group (p<0.001; p=0.024 and p=0.010, respectively). Pain syndrome determined by VAS 3 days after the surgery was significantly lower in the epivastus group (p=0.006). The extent of blood loss appeared to be much greater in MMPA group (p=0.006). The joint function indicators on day 3 after the surgery were found to be better in the patients after TKA using an epivastus approach (p<0.001). The postoperative assessment of the endoprosthetic spatial orientation showed the indicators characterizing the correct endoprosthetic implantation to be comparable in both groups (p≥0.06).

Conclusion: The present study demonstrated the efficiency of the developed minimally invasive (epivastus) approach in TKA. However, it should be taken into consideration that surgeons should take a training course to be able to accomplish a high-quality approach.An ambiguous interpretation of tissue trauma markers assessment of performing minimally traumatic approaches requires terminology correction. It is probably necessary to change the approach to the approach marking and use the terms specifying minimal invasiveness and the reduction of muscle injury rather than soft tissues in general.

全膝关节置换术的微创(上睑)入路
该研究旨在通过比较已开发的微创(外侧)方法与标准髌骨内侧方法(MMPA)的早期效果,评估微创(外侧)方法在全膝关节置换术(TKA)中的效率:这是一项单中心、随机前瞻性对比研究,共有127名患者参加,他们在2022年1月至12月期间分别接受了MMPA(62人)和改良微创外髁入路(65人)的全膝关节置换术。研究组的性别、年龄、体重指数、关节病分期和膝关节功能参数具有可比性:结果:与 MMPA 组相比,epivastus 组的手术时间明显较短(p):本研究证明了所开发的微创(上腹部)方法在 TKA 中的有效性。但应注意的是,外科医生应参加培训课程,以便能够完成高质量的方法。对组织创伤标记评估的模糊解释需要对微创方法进行术语纠正。也许有必要改变入路标记的方法,使用指定微创和减少肌肉损伤的术语,而不是一般的软组织。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Sovremennye Tehnologii v Medicine
Sovremennye Tehnologii v Medicine MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
1.80
自引率
0.00%
发文量
38
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