Strength and Voluntary Activation of Quadriceps Femoris Muscle in Total Knee Arthroplasty with Midvastus and Subvastus Approaches

Abstract To determine and compare the influence of 2 different approaches on quadriceps femoris muscle function in total knee arthroplasty (TKA), 20 patients (14 women, 6 men) with bilateral knee osteoarthritis underwent a 1-stage bilateral TKA. Surgical approaches (subvastus, midvastus) were perfor...

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Bibliographic Details
Published in:The Journal of arthroplasty 2007, Vol.22 (1), p.83-88
Main Authors: Berth, Alexander, MD, Urbach, Dietmar, MD, Neumann, Wolfram, MD, Awiszus, Friedemann, MD, MSc
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
approach
Arthralgia - etiology
arthrogenous muscle inhibition
arthroplasty
Arthroplasty, Replacement, Knee - adverse effects
Arthroplasty, Replacement, Knee - methods
Female
Humans
knee
Knee Joint - physiopathology
Knee Joint - surgery
Male
Middle Aged
Muscle Contraction - physiology
muscle strength
Muscle Strength - physiology
Orthopedics
osteoarthritis
Osteoarthritis, Knee - surgery
Quadriceps Muscle - physiology
Quadriceps Muscle - surgery
twitch interpolation
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Summary:Abstract To determine and compare the influence of 2 different approaches on quadriceps femoris muscle function in total knee arthroplasty (TKA), 20 patients (14 women, 6 men) with bilateral knee osteoarthritis underwent a 1-stage bilateral TKA. Surgical approaches (subvastus, midvastus) were performed by a random selection. Measurements of quadriceps voluntary activation and maximal voluntary contraction were estimated by a twitch interpolation technique before, 3 and 6 months after TKA. Knee pain was quantified by the Lewis Score. There was no difference between the 2 approaches at 3 and 6 months after TKA with regard to maximal voluntary contraction ( P = 0.84, F = 0.041) and voluntary activation ( P = .863, F = 0.031). In the subvastus group was a significantly higher knee pain until 6 months after surgery ( P = .02). The subvastus approach for TKA does not provide any advantages compared with the midvastus approach with respect to the quadriceps femoris muscle strength in the early postoperative period. Furthermore, the subvastus approach caused significantly more pain postoperatively.
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2006.02.161