Quadriceps sparing knee replacement: Is it a better operation?
By: Stephen J. Zabinski, MD
A retrospective review and comparison to traditional knee replacement surgery from the patient’s perspective
If doctors can perform knee replacement surgery without cutting through the quadriceps muscle and tendon of the thigh, it makes sense that patients should have less pain and an easier rehabilitation than in traditional more invasive surgical techniques. Or does it?
Total knee replacement surgery has become one of the most frequently performed surgeries in the United States. Over time, as with any surgical technique, surgeons have sought new ways to perform the surgery less invasively with the goals of diminishing postoperative pain and improving recovery time.
This has happened with traditional total knee replacement surgery. Surgeons have worked on techniques to implant a total knee replacement device without cutting the quadriceps muscle and tendon as they do in traditional surgery.
Despite the theoretical benefits, some studies have not documented any improvement in results with quadriceps sparing total knee replacement in comparison to traditional knee replacement surgery.
To that end, the surgeons of Shore Orthopaedic University Associates (who have worked to learn and perfect sub-vastus quadriceps sparing knee replacement for several years) hired an independent firm to perform a study of their patients who underwent sub-vastus quadriceps sparing knee replacement surgery in 2011-2012.
The study was comprised of 113 patients who had all undergone quad-sparing knee replacement by a single surgeon. The group of main focus were patients who had undergone a previous traditional total knee surgery and then had the other knee replaced using the less invasive technique. Their short-term outcome, which included postoperative pain, rehab time and overall satisfaction with the quad sparing technique, was compared to their prior experience with traditional knee replacement.
In comparing their post-operative pain, 75.8 percent of patients experienced less post-operative pain with quad sparing knee replacement surgery in comparison to their traditional knee replacement surgery.
The overall amount of postoperative physical therapy and time to return to a normal lifestyle was significantly less than with traditional knee replacement for 67 percent of patients. This correlated to the patient’s length of hospital stay (which averaged less than 48 hours) and their total time utilizing a walker and cane before normalizing to walking on their own (which averaged a total of 20 days); both of which are less than national averages.
Overall satisfaction with the outcome of knee replacement was greater in 78 percent of patients in comparing their sub-vastus quadriceps sparing surgery to their prior traditional knee replacement
Some 94 percent said that, given the opportunity, they would be very likely to recommend sub-vastus quadriceps sparing knee replacement to friends and family.
While listening to a physician’s advice is important, the opinion of our friends and family who have previously undergone the procedure also matters greatly in the decision process. Sub-vastus quadriceps sparing knee replacement should be strongly considered when making the decision to replace a painful knee.
The surgeons of Shore Orthopaedic University Associates can discuss this surgery option with you. Call (609) 927-1991 or see www.shoreorthodocs.com to schedule a one-on-one consultation with a Shore Orthopaedic physician.
Somers Point, NJ
Cape May Court House, NJ
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