Total knee arthroplasty: better short-term results after subvastus approach: a randomized, controlled study

The purpose of this study was to evaluate the short-term results after performing a total knee arthroplasty (TKA) using two surgical approaches: the subvastus approach (SV) and the conventional parapatellar approach. It was hypothesized that the SV approach would achieve the best short-term benefits. This is a randomized prospective and double-blind study that includes 104 patients. Evaluations were carried out preoperatively, when discharged (5 days) at one, three, and 12 postoperative months. The SV group showed significantly better range of movement and quadriceps extensor force when discharged. Statistically significant differences were found that showed a distinct improvement in favour of the SV group at one month in terms of extensor force and according to the Barthel Index. No significant difference was found between the two groups at the 12 month evaluation. It was concluded that the SV approach offers superior short-term clinical and functional results and it was shown that this approach also offers a significant advantage to the patient in the immediate postoperative period, although these differences tend to disappear over time following TKA. We strongly recommend the SV approach in the majority of TKA.