Mid-Term Follow Up Results of Mini-Subvastus Approach for Total Knee Arthroplasty in Obese Patients
Background: Use of mini-subvastus approach for total knee arthroplasty (TKA ) in obese patients is still debated . We had hypothesized in our study published in July 2010 , that obesity should not be considered as a problem for patients undergoing a TKA with the mini-subvastus approach as the anatomy of the quadriceps in the obese and the non-obese patient population is the same. We present a mid-term follow-up study of the same set of patients with an average follow up of 96 months.
Materials and Methods: 97 obese patients (109 knees) 81 females + 16 males with mean age 64 years underwent TKA by mini-subvastus approach between January 2006 to July 2007. 16 patients (18 knees) were morbidly obese. Out of the total number of patients, 08 were lost in follow up and 01 died because of unrelated causes. Out of these 09 patients, two were operated for bilateral TKR. Thus, we have a midterm follow up results of 98 knees in 88 patients. Knee society and functional scores were used for patient evaluation and compared to their pre-operative and earlier follow up scores.
Results: At our latest follow-up of 96 months the Knee Society Score and functional scores were 84(range 64-90) and 58(range 45-75) respectively. One morbidly obese lady had aseptic loosening of tibial component at 42 months which needed a revision.
Conclusion: Our mid-term results show that the mini-subvastus approach can be considered for TKA in obese and morbidly obese patient population with outcomes comparable to standard surgical approach.
Keywords: Mini-subvastus approach, Total knee arthroplasty ,Obesity
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