CompletedPhase 1ACTRN12606000376549

An evaluation of the clinical outcomes of the subvastus versus the medial parapatella approach to total knee replacement

An evaluation of the clinical outcomes (American Knee Society Score, Knee Range of Motion, Quadriceps Function, Functional Mobility, Pain, Patella Vascularity) of the subvastus versus the medial parapatella approach to total knee replacement

Sponsor

Queensland Health

Enrollment

64 participants

Start Date

Jul 14, 2006

Study Type

Interventional

Conditions

Total Knee Replacement

Summary

Study Hypothesis: We hypothesise that participants receiving the subvastus approach will enjoy better medium term funtional outcomes than those receiving the medial parapatell approach. Physiotherapists are blinded to the intervention and will collect all outcome measures at each assessment point. Participants are blinded to the intervention.

Eligibility

Sex: Both males and femalesMin Age: 18 Yearss

Inclusion Criteria1

Adult participants. The expected age range of subjects undergoing total knee replacement surgery is between 50 and 65 years. Patients undergoing primary unilateral total knee replacement. Diagnosis of osteoarthritis. Healthy and no comorbidities that would prevent participating in the required rehabilitation programme. Normal mentation with the ability to accurately follow commands. Ability to attend supervised outpatient physiotherapy rehabilitation session(s) after being discharged from hospital. Ability to participate voluntarily and provide signed informed consent.

Exclusion Criteria1

Persons with concomitant medical conditions such as malignant tumours or severe Chronic Obstructive Pulmonary Disease that would prevent participation in the required rehabilitation programme. Lateral surgical approach required. Inability to follow commands. Persons not able to mobilise in a bipedal manner with or without a walking aid. Conditions preventing full weight bearing post-operatively. The inability to provide signed informed consent. Revision TKR or any previous major arthrotomy or previous High Tibial Osteotomy on the knee to be operated onLess than 70 degrees of flexion. Persons undergoing bi-lateral total knee replacements. Persons identified as being unlikely to follow Queensland Health's TKR Clinical Pathway (e.g. requiring admission to the rehabilitation unit preoperatively) Greater than 15 degree FFD (Fixed flexion deformity).

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Interventions

Medial Parapatella approach to Total Knee Replacement involves dissection through the quadriceps. The Subvastus approach does not. Assessments will be performed at PreOperative Period, Days 1,2,3; 6

Medial Parapatella approach to Total Knee Replacement involves dissection through the quadriceps. The Subvastus approach does not. Assessments will be performed at PreOperative Period, Days 1,2,3; 6 Weeks, 6 months, 12 months and 18 months post operatively