Article

A Retrospective Analysis of the Modified Intervastus Approach

Author and Disclosure Information

TAKE-HOME POINTS

  • The modified intervastus approach to the knee spares the quadriceps tendon and the vastus medialis muscle.
  • The modified intervastus approach is an extensile approach.
  • The modified intersvastus approach is a safe approach to the knee that can be used in total knee arthroplasty and leads to early straight-leg raise and a rapid recovery.
  • The modified intervastus approach can be used on the majority of patients requiring a total knee replacement.
  • The modified intervastus approach utilizes a unique closure that avoids soft tissue strangulation.


 

References

ABSTRACT

The subvastus (SV) approach is a well-known muscle- and tendon-sparing approach for total knee arthroplasty (TKA), which has been shown in some studies to provide better outcomes in the visual analog pain score (VAS), knee range of motion (ROM), straight-leg raise, as well as faster rehabilitation, compared with the standard medial parapatellar (MP) approach. We previously described a new knee replacement technique known as the modified intervastus (MIV) approach. The MIV approach is a muscle- and tendon-sparing approach that is extensile and simple to perform. It may be used in the majority of complex primary cases and revisions. Here we describe the surgical technique for performing the MIV approach and provide functional outcome measures. A total of 127 patients (mean age, 66.75 years) underwent TKA using the MIV approach with 1-year follow-up. Clinical outcomes were assessed by recording both a VAS and knee ROM preoperatively, and again at several postoperative time points when the length of time required to ambulate independently (without assistive devices) was also measured. The VAS decreased significantly from the preoperative period (3.69 ± 2.22) to postoperative day 1 (3.17 ± 1.97) (P < .05). Although knee ROM decreased 1 week after surgery, the ROM increased by 6 weeks after surgery compared with the preoperative ROM, and the trend continued over the 1-year follow-up. One-third (33%) of patients were able to walk independently (without assistive devices) at 2 weeks and 78% at 8 weeks. The MIV approach to the knee is a muscle- and tendon-sparing approach that offers advantages over the SV approach and may be used for complex primary and revision total knee cases.

Continue to: Total knee arthroplasty...

Pages

Recommended Reading

Complications cluster in inflammatory arthritis patients after total knee replacement
MDedge Surgery
Total knee replacement risk soars after arthroscopic surgery for meniscal tear
MDedge Surgery
The Flint Lock: A Novel Technique in Total Knee Arthroplasty Closure
MDedge Surgery
Mycobacterium abscessus: A Rare Cause of Periprosthetic Knee Joint Infection
MDedge Surgery
Composite Fixation of Proximal Tibial Nonunions: A Technical Trick
MDedge Surgery
Knee Injuries in Elite Level Soccer Players
MDedge Surgery
Safety and Efficacy of Percutaneous Injection of Lipogems Micro-Fractured Adipose Tissue for Osteoarthritic Knees
MDedge Surgery
Geniculate Artery Injury During Primary Total Knee Arthroplasty
MDedge Surgery
Review of Common Clinical Conditions of the Proximal Tibiofibular Joint
MDedge Surgery
Incidental Asymptomatic Fibular Stress Fractures Presenting as Varus Knee Osteoarthritis: A Case Report
MDedge Surgery