Abstract
Background
The number of total knee arthroplasties (TKA) has increased steadily with the aging
of the population. This surgical procedure is recognized for its success in pain relief
and restoration of knee function. However, decreased quadriceps femoris (QF) muscle
strength after TKA is frequently observed but with unknown etiology. Evidence suggests
that the location of the operative incision (i.e., surgical access) can influence
QF muscle structure and function. The present study aimed to assess the fiber type
composition, structure and assembly of the QF's vastus medialis (VM) and vastus lateralis
(VL) muscles before and after TKA.
Methods
Muscle biopsies (VM and VL muscles) were collected from patients previously submitted
to TKA via the medial parapatellar route and undergoing TKA revision (main group,
n = 9) and patients with osteoarthrosis (OA) who were due to undergo TKA (control
group: n = 18). The biopsied muscle tissue was prepared, stored, and then sectioned
in a cryostat at −25 °C. The tissue sections were evaluated using routine staining
techniques in pathological anatomy and histochemistry.
Results
The normal mosaic pattern of the medial and lateral knee muscles was observed in the
main and control groups, with no evidence of peripheral nerve damage. Notably, 88.9 %
of the patients exhibited mild to severe VL atrophy, while only 11.1 % of patients
in the control group presented this feature (P < 0.001).
Conclusions
The medial parapatellar incision for TKA surgical access does not generate definitive
morphological changes in the VM and VL muscle fibers but may contribute to VL atrophy.
Keywords
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Article info
Publication history
Published online: November 17, 2022
Accepted:
October 27,
2022
Received in revised form:
August 7,
2022
Received:
March 24,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
