The Journal of Arthroplasty
Volume 22, Issue 1 , Pages 83-88, January 2007

Strength and Voluntary Activation of Quadriceps Femoris Muscle in Total Knee Arthroplasty with Midvastus and Subvastus Approaches

  • Alexander Berth, MD

      Affiliations

    • Department of Orthopaedics, Otto-von-Guericke- University, Magdeburg, Germany
    • Corresponding Author InformationReprint requests: Alexander Berth, MD, Orthopädische Univers itätsklinik, Otto-von-Guericke Universität, Leipziger Str. 44, 39120 Magdeburg, Germany.
    • ,
  • Dietmar Urbach, MD

      Affiliations

    • Department of Orthopaedics, Otto-von-Guericke- University, Magdeburg, Germany
    • ,
  • Wolfram Neumann, MD

      Affiliations

    • Department of Orthopaedics, Otto-von-Guericke- University, Magdeburg, Germany
    • ,
  • Friedemann Awiszus, MD, MSc

      Affiliations

    • Neuromuscular Research Group of the Department of Orthopaedics, Otto-von-Guericke- University, Magdeburg, Germany

Received 4 June 2005; accepted 26 February 2006.

Abstract 

To determine and compare the influence of 2 different approaches on quadriceps femoris muscle function in total knee arthroplasty (TKA), 20 patients (14 women, 6 men) with bilateral knee osteoarthritis underwent a 1-stage bilateral TKA. Surgical approaches (subvastus, midvastus) were performed by a random selection. Measurements of quadriceps voluntary activation and maximal voluntary contraction were estimated by a twitch interpolation technique before, 3 and 6 months after TKA. Knee pain was quantified by the Lewis Score. There was no difference between the 2 approaches at 3 and 6 months after TKA with regard to maximal voluntary contraction (P = 0.84, F = 0.041) and voluntary activation (P = .863, F = 0.031). In the subvastus group was a significantly higher knee pain until 6 months after surgery (P = .02). The subvastus approach for TKA does not provide any advantages compared with the midvastus approach with respect to the quadriceps femoris muscle strength in the early postoperative period. Furthermore, the subvastus approach caused significantly more pain postoperatively.

Key words: osteoarthritis, knee, arthroplasty, approach, muscle strength, arthrogenous muscle inhibition, twitch interpolation

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 Benefits or funds were received in partial or total support of the research material described in this article from Deutsche Forschungsgemeinschaft AW 5/2 – 4.

PII: S0883-5403(06)00260-9

doi:10.1016/j.arth.2006.02.161

The Journal of Arthroplasty
Volume 22, Issue 1 , Pages 83-88, January 2007

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