International orthopaedics · 2026
The effect of J-shaped incision versus standard midline incision on numbness and pain in primary total knee arthroplasty: a prospective randomized controlled trial.
СтатьяРандомизированное исследованиеСравнительное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Kahraman Hamit Çağlayan, Kılınç Bekir Eray, Yavuz Olcay, Erdem Hamza Fevzi, Yılmaz Barış
Аннотация
INTRODUCTION: Peri-incisional numbness is a common but often underestimated complaint after primary total knee arthroplasty (TKA) and may negatively affect early postoperative patient satisfaction. This randomized controlled trial aimed to determine whether a modified J-shaped skin incision, created by lateralizing the distal limb of the standard midline incision by 3 cm at the tibial tuberosity, reduces peri-incisional numbness and pain after primary TKA.
MATERIALS AND METHODS: Sixty-two patients undergoing primary TKA for Kellgren-Lawrence grade 4 osteoarthritis were randomized to either a standard midline incision or a modified J-shaped incision. All procedures were performed using a medial parapatellar arthrotomy and standardized perioperative protocols. The primary outcome was the area of postoperative anterior knee numbness, assessed using grid-based 10-g Semmes-Weinstein monofilament mapping at two and six months. Secondary outcomes included VAS pain, WOMAC, KOOS, HSS, Kujala score, range of motion, and perioperative parameters.
RESULTS: Baseline demographic and perioperative characteristics were comparable between groups, except for longer incision length in the J-shaped group. The standard incision group had a significantly larger sensory deficit area than the J-shaped group at both two months and six months postoperatively (7.6 ± 4.2 vs. 3.5 ± 2.9 cm. 2 and 5.3 ± 3.2 vs. 2.1 ± 2.4 cm. 2, respectively; both p < 0.01). Postoperative VAS pain was significantly lower in the J-shaped group at six months (p = 0.048). Functional outcomes improved significantly in both groups, with no significant between-group differences.
CONCLUSIONS: The modified J-shaped skin incision significantly reduced peri-incisional numbness and early postoperative pain after primary TKA without increasing complications. This simple incision modification may improve early sensory recovery while preserving standard medial surgical exposure.
TRIAL REGISTRATION: ClinicalTrials.gov, NCT07514598, ( https://clinicaltrials.gov/study/NCT07514598 ).
MATERIALS AND METHODS: Sixty-two patients undergoing primary TKA for Kellgren-Lawrence grade 4 osteoarthritis were randomized to either a standard midline incision or a modified J-shaped incision. All procedures were performed using a medial parapatellar arthrotomy and standardized perioperative protocols. The primary outcome was the area of postoperative anterior knee numbness, assessed using grid-based 10-g Semmes-Weinstein monofilament mapping at two and six months. Secondary outcomes included VAS pain, WOMAC, KOOS, HSS, Kujala score, range of motion, and perioperative parameters.
RESULTS: Baseline demographic and perioperative characteristics were comparable between groups, except for longer incision length in the J-shaped group. The standard incision group had a significantly larger sensory deficit area than the J-shaped group at both two months and six months postoperatively (7.6 ± 4.2 vs. 3.5 ± 2.9 cm. 2 and 5.3 ± 3.2 vs. 2.1 ± 2.4 cm. 2, respectively; both p < 0.01). Postoperative VAS pain was significantly lower in the J-shaped group at six months (p = 0.048). Functional outcomes improved significantly in both groups, with no significant between-group differences.
CONCLUSIONS: The modified J-shaped skin incision significantly reduced peri-incisional numbness and early postoperative pain after primary TKA without increasing complications. This simple incision modification may improve early sensory recovery while preserving standard medial surgical exposure.
TRIAL REGISTRATION: ClinicalTrials.gov, NCT07514598, ( https://clinicaltrials.gov/study/NCT07514598 ).