The Examination And Investigation Of The Mid-Vastus (MV) Minimally Invasive Approach, And The Standard Medial Para-Pattelar (MPP) Surgical Exposure To Total Knee Arthroplasty(TKA) Surgery With A View To Determining Which If Any Is More Beneficial To Knee Osteoarthritis Patients Six Months Post Operation.
Notice bibliographique
Résumé
Background\nTrousdale et al, (1999) showed that postoperative pain, the recovery time required, and the management of it was of paramount concern to the patient prior to total knee replacement (TKR). Prevalence of total knee arthroplasty (TKA) is on the rise (Trousdale et al., 1999). Europe’s population is ageing with each passing decade and with it the need for more improved medical procedures and techniques for this population sector, but not solely for same.\nThis same ageing population has greater expectations than ever before of a longer life, better quality of life, greater independence to do things they want to do and reduced dependency on others. To so many of the people suffering from chronic knee problems the marvel that is TKR is at the forefront of the revolution that is allowing these people to live again rather than being limited to the home environment and ultimately becoming dependent on others.\nThe standard medial-parapatellar (MPP) procedure is the gold standard approach for TKR surgery with approximately 93% of primary cemented TKA’s in England and Wales using the MPP approach (Alcelik et al., 2011). For the aforementioned reasons a relatively recent development in TKA surgery known as the mid - vastus (MV) approach, utilized in 3% of surgical procedures in England and Wales Alcelik et al, (2011), was developed with this approach aiming to reduce disruption/damage to the soft tissues during surgery, and by minimising the damage to the quadriceps this procedure could potentially hasten post - operative recovery and decrease post - operative pain and blood loss during surgery.\nAims\nTo investigate whether there was a significant difference between the MV and MPP surgical approaches in the changes between pre - operation and six months post - operation. This was achieved using three functional outcome measures and three patient report outcome measures (PROM’s)\nFunctional outcome measures:\n1. Pain intensity.\n2. Active knee range of motion (ROM).\n3. Timed up and go test (TUG).\nPatient report outcome measure (PROM’s).\n1. Canadian outcome performance measure (COPM).\n2. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)\n3. EuroQol Group 5-Dimension (EQ-5D).\nMethods\nFrom the original study only twenty eight TKA’s were performed - sixteen MPP approaches and twelve MV approaches. A secondary data analysis was completed for all six outcome measures. The statistical tests used to test differences between the standard MPP group and the MV group were independent t-tests for parametric data and Mann Witney U test for non parametric data.\nPaired sample t- tests (parametric) and Wilcoxon signed ranks test (non parametric) were used to test for differences within the two groups.\nResults\nDescriptive and inferential statistics were used to analyse the differences between and within groups, the MPP and MV. Overall no significant differences were found between the groups for any of the six outcome measures utilized.\nThe within group testing however found statistical differences in the pain intensity, COPM, WOMAC, and EQ-5D data sets. The TUG data set found significant differences within the MPP group however no significant difference was found in the MV group. Finally no significant differences were detected for the ROM data set.\nConclusion\nThe MV approach offers advantages over the standard MPP approach in the relatively early rehabilitation period, with these seeming to diminish over time. The MV approach should be considered as a valuable alternative to the MPP approach in TKA however further comparative studies are needed to resolve this debate.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».