Evidence map›Paper›PMID 22806264›Full record

Trial reportClinical orthopaedics and related research2013

The John Insall award: no benefit of minimally invasive TKA on gait and strength outcomes: a randomized controlled trial.

Julien Wegrzyn, Sebastien Parratte, Krista Coleman-Wood, Kenton R Kaufman, Mark W Pagnano

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Clinical orthopaedics and related research, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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  6. A meta-analysis of minimally invasive and conventional medial parapatella approaches for primary total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2015
    Pooled it
  7. Post-operative limb position can influence blood loss and range of motion after total knee arthroplasty: a systematic review.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2015
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  10. Effect of different postoperative flexion regimes on the outcomes of total knee arthroplasty: randomized controlled trial.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2017
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  15. Better outcomes after mini-subvastus approach for primary total knee arthroplasty: a Bayesian network meta-analysis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2020
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  16. Article
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  19. Medial subvastusEFORT open reviews · 2018
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Julien WegrzynDepartment of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
Sebastien Parratte
Krista Coleman-Wood
Kenton R Kaufman
Mark W Pagnano

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWhile some clinical reports suggest minimally invasive surgical (MIS) techniques improve recovery and reduce pain in the first months after TKA, it is unclear whether it improves gait and thigh muscle strength. QUESTIONS/PURPOSES: We hypothesized TKA performed through a mini-subvastus approach would improve subjective and objective and subjective function compared to a standard medial parapatellar approach 2 months after surgery.

methodsWe randomized 40 patients into two groups using either the mini-subvastus approach or standard medial parapatellar approach. Patients were evaluated preoperatively and 2 months after surgery. We assessed subjective functional outcome and quality of life (QOL) using routine questionnaires (SF-12, Knee Society Score [KSS], Knee Injury and Osteoarthritis Outcome Score [KOOS], UCLA activity, patient milestone diary of activities). We determined isometric strength of the thigh muscles and assessed gait with a three-dimensional (3-D) analysis during level walking and stair climbing.

resultsWe observed improvements from preoperatively to 2 months postoperatively in functional scores, QOL, and knee kinematic and kinetic gait parameters during level and stair walking. Isometric quadriceps strength increased in both groups, although remaining lower when compared to sound limbs. We found no differences between the groups in KSS, SF-12, KOOS, UCLA activity, patient milestone diary of activities, isometric quadriceps strength, or 3-D gait parameters, except a marginally higher speed of stair ascent in the MIS group.

conclusionsOur observations suggest an MIS approach does not confer a substantial advantage in early function after TKA. LEVEL OF EVIDENCE: Level I, therapeutic study. See Instructions to Authors for a complete description of levels of evidence.

Indexed as

AgedAged, 80 and overArthroplasty, Replacement, KneeAwards and PrizesFemaleGaitHumansKnee JointMaleMiddle AgedMinimally Invasive Surgical ProceduresMuscle StrengthOsteoarthritis, KneeQuadriceps MuscleQuality of LifeRecovery of Function

Identifiers

PMID22806264
PMCPMC3528913

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.