Difference in stair negotiation ability based on TKA surgical approach

J Knee Surg. 2011 Jun;24(2):117-23. doi: 10.1055/s-0031-1280882.


Several surgical approaches for total knee arthroplasty (TKA) have been developed to minimize soft-tissue trauma and expedite functional recovery. A group of 61 subjects undergoing computer-navigated, minimally invasive TKA were randomized to receive a mini-parapatellar, standard parapatellar, mini-midvastus (MV), or mini-subvastus approach. Before and after treatment, subjects were asked to negotiate stairs in a self-selected manner. This study used the manner of stair negotiation (i.e., use of handrail, step-over-step, step-by-step) as a proxy for functional ability. Subjects who received TKA through a mini-MV approach demonstrated a significantly lower level of function at 2 and 4 months. If early functional recovery is a goal of TKA, surgeons should be cautious when considering the mini-MV approach, which was found to be inferior to other approaches in this study.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Knee / methods*
  • Arthroplasty, Replacement, Knee / rehabilitation
  • Biomechanical Phenomena
  • Female
  • Humans
  • Knee Joint / physiopathology
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures
  • Movement / physiology
  • Osteoarthritis, Knee / physiopathology
  • Osteoarthritis, Knee / surgery
  • Prospective Studies
  • Recovery of Function