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Does Minimally Invasive Total Knee Arthroplasty Improve Isokinetic Torque?

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Less invasive dissection of the extensor apparatus, one of the aspects of minimally invasive surgical (MIS) TKA, might result in less reduction of postoperative quadriceps strength. However, it is unclear whether MIS is associated with less strength reduction.

Questions/purposes

We asked whether knee strength (extensor or flexor torque) would be greater in patients having a MIS TKA compared with patients having a standard TKA and whether knee scores, alignment, ROM, tourniquet and operating times, and hospital length of stay were improved.

Methods

We prospectively recruited 52 patients awaiting MIS or standard TKA, matched for age, weight, height, BMI, sex, and surgically treated side, but not randomized. Isokinetic tests were performed preoperatively and postoperatively to obtain peak values of extensor and flexor torque. Postoperative-to-preoperative ratios and the extensor-flexor torque ratio also were calculated.

Results

Mean baseline extensor torques were 57 Nm and 53 Nm for MIS and standard TKAs, respectively. At 8 weeks postoperatively, absolute values of the mean postoperative knee extensor torque also were similar: 47 and 45 Nm for patients with MIS and standard TKAs, respectively. The postoperative-to-preoperative ratios were 0.8 for extensor and flexor torque in both groups. The extensor-flexor torque ratios were similar between groups.

Conclusions

Our data suggest a less invasive dissection of the extensor apparatus involved in MIS TKA does not enhance postoperative quadriceps strength.

Level of Evidence

Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Hannes Behensky MD and Peter Kapfinger MD for contribution of the MIS TKA cases. We thank Johannes Giesinger PhD for advice on statistical questions.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria

    Michael C. Liebensteiner MD, PhD, Martin Krismer MD & Eckart Mayr MD

  2. Institute for Sports Medicine, Alpine Medicine and Health Tourism, Natters, Austria

    Arnold Koller PhD

  3. Department of Internal Medicine, Innsbruck Medical University, Innsbruck, Austria

    Barbara Semenitz MD

Authors
  1. Michael C. Liebensteiner MD, PhD
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  2. Martin Krismer MD
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Corresponding author

Correspondence to Michael C. Liebensteiner MD, PhD.

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Each author certifies that he or she, or a member of their immediate family, has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at Innsbruck Medical University, Innsbruck, Austria.

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Liebensteiner, M.C., Krismer, M., Koller, A. et al. Does Minimally Invasive Total Knee Arthroplasty Improve Isokinetic Torque?. Clin Orthop Relat Res 470, 3233–3239 (2012). https://doi.org/10.1007/s11999-012-2545-7

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  • DOI: https://doi.org/10.1007/s11999-012-2545-7

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