Publication: Comparison of accuracy between side-cutting instruments and front-cutting instruments in minimally invasive total knee arthroplasty
Issued Date
2016-11-01
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01252208
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2-s2.0-85010917008
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of the Medical Association of Thailand. Vol.99, No.11 (2016), 1185-1191
Suggested Citation
Piya Pinsornsak, Thos Harnroongroj Comparison of accuracy between side-cutting instruments and front-cutting instruments in minimally invasive total knee arthroplasty. Journal of the Medical Association of Thailand. Vol.99, No.11 (2016), 1185-1191. Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/41052
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Title
Comparison of accuracy between side-cutting instruments and front-cutting instruments in minimally invasive total knee arthroplasty
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Abstract
© 2016, Medical Association of Thailand. All rights reserved. Background: The specialized instrument system used in minimally invasive surgery (MIS) has been developed for reducing soft tissue trauma in total knee arthroplasty (TKA). Compared with front-cutting MIS instruments, side-cutting quadriceps sparing MIS instruments have the advantage of creating a smaller incision and causing fewer traumas to the quadriceps tendon. However, the accuracy of side-cutting instruments concerns surgeons in prosthesis malalignment. Objective: To compare the accuracy of side-cutting quadriceps sparing instruments versus front-cutting instruments in MIS-TKA. Material and Method: In this prospective randomized controlled study, we compared the accuracy of side-cutting quadriceps sparing instruments versus the front-cutting instruments used in MIS-TKA. Sixty knees were included in the study, with 30 knees in each group. All the operations were performed by single surgeon. Coronal alignment (tibiofemoral angle, lateral distal femoral angle, and medial proximal tibial angle), and sagittal alignment (femoral component flexion and tibial posterior slope) were measured and compared. Results: Tibiofemoral angle, lateral distal femoral angle, and medial proximal tibial angle, all of which are considered in the assessment of acceptable coronal radiographic alignment, were not different between groups (p = 0.353, 0.500, and 0.177, respectively). However, side-cutting quadriceps sparing instruments produced less acceptable sagittal radiographic alignment, femoral component flexion (63% vs. 93%, p = 0.005), and tibial posterior slope (73% vs. 93%, p = 0.04). Conclusion: Side-cutting quadriceps sparing MIS-TKA instruments had similar accuracy to front-cutting MIS-TKA instruments for coronal alignment but is less accurate for sagittal alignment.