THE BIGGEST MOB HIT IN YEARS

Quadriceps Sparing Knee Replacement…Is it a better operation?
A retrospective review and comparison to traditional knee replacement surgery from the patient’s perspective
By Dr. Stephen J. Zabinski
If you can perform knee replacement surgery without cutting through the quadricep muscle and tendon of the thigh it makes sense that
those patients should have less pain and an easier rehabilitation than traditional, more invasive, surgical techniques. Or does it?
Total knee replacement surgery has become one of the most frequently performed surgeries in the United States. Over time, as
with any surgical technique, surgeons have sought new ways to perform the operation less invasively, with the goals of diminishing
postoperative pain and improving recovery time.
This has happened with traditional total knee replacement surgery. Surgeons have worked on techniques to implant a total knee
replacement device without cutting the quadricep muscle and tendon as they do in traditional surgery.
Despite the theoretical benefits, some studies have not documented any improvement in results with quadriceps sparing total knee
replacement in comparison to traditional knee replacement surgery.
To that end, the surgeons of Shore Orthopaedic University Associates (who have worked to learn and perfect Sub-vastus Quadriceps
Sparing Knee Replacement for several years) hired an independent firm to perform a study on their patients who underwent Sub-vastus
Quadriceps Sparing Knee Replacement Surgery in 2011-2012.
The study was comprised of 113 patients who had all undergone quad sparing knee replacement by a single surgeon. The group of main
focus were patients who had undergone a previous traditional total knee surgery and now were having the other knee replaced using
the less invasive quadriceps sparing technique. Their short term outcome, which included post operative pain, rehab time and overall
satisfaction with the quad sparing technique, was compared to their prior experience with traditional knee replacement.
In comparing their post operative pain, 75.8 % of patients experienced less post operative pain with quad sparing knee replacement
surgery in comparison to their prior traditional knee replacement surgery.
For 67% of patients, the overall amount of post operative physical therapy and time to return to a normal lifestyle was significantly less
than their prior traditional knee replacement. This correlated to the patient’s length of hospital stay (which averaged less than 48 hours)
and their total time utilizing a walker and cane before normalizing to walking on their own (which averaged a total of 20 days); both of
which are less than national averages.
Overall satisfaction with the outcome of their knee replacement was greater in 78% of patients when comparing their Sub-vastus
Quadriceps Sparing Surgery to their prior traditional knee replacement
Lastly, as far as recommending the Sub-vastus Quadriceps Sparing Knee Replacement to friends and family, 94% agreed they would be
very likely to recommend this procedure.
When it comes to recommendations, we all know we listen to our physician’s advice, however the opinion of our friends and family who
have previously undergone the procedure also matters greatly in our decision process. So the verdict is in: Sub-vastus Quadriceps
Sparing Knee Replacement should be strongly considered when making the decision to replace your painful knee.
Direct Anterior Approach Provides Benefits for Total Hip Replacement
Hip replacement may be needed if you have severe pain from an arthritic hip, a tumor in the hip joint or a fracture in the femur.
The majority of people who need hip replacement are in their 60s and 70s. However, people in their late teens and in their 90s
have hip replacement surgery as well. Traditional total hip replacement surgery requires cutting or disturbing the important
muscles at the side or back of the leg. Some people require precautions, limiting motion during the first 6 weeks after surgery to
decrease the risk of the replacement dislocating (popping out of place).
The Direct Anterior Approach for total hip replacement is a new tissue-sparing alternative to traditional hip replacement surgery
that provides the potential for less pain, faster recovery and improved mobility because the muscle tissues are spared during
the surgical procedure. Most people have: Good muscular control and strength immediately after surgery; Walk the same day of
surgery, often with just a single cane; Leave the hospital 24 to 48 hours after surgery and go directly home; Have no restrictions
in regard to their hip replacement and can return to driving within a week after surgery.
Shore Medical Center – South Jersey’s Leading Surgical Pavilion
Sub-vastus Quadriceps Sparing knee placement and Direct Anterior Approach hip replacement surgery are performed at Shore
Medical Center’s state-of-the-art Surgical Pavilion, which features nine of the region’s most advanced surgical suites and the
technology needed to ensure the best surgical outcomes possible. For information on Shore Medical Center, call 609.653.3500
or visit www.ShoreMedicalCenter.org.
Call us today to get back to what you love to do.
From muscular strains and fractures to arthritic conditions, the physicians and staff of Shore Orthopaedic University Associates
are trained in the diagnosis and treatment of musculoskeletal problems, including those affecting the knees and hips. We can be
reached at www.ShoreOrthoDocs.com or 609.927.1991 to schedule a one-on-one consultation with our physicians.
The Boardwalk Journal | May 2013 | 43