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Subvastus versus Medial Parapatellar Approach in Primary Total Knee Replacement: An Assessment of Early Function
M E Ugbeye1, S E Itakpe, O J Ayodabo
1Arthroplasty Division, Department of Orthopaedics and Trauma, National Orthopaedic Hospital Igbobi, Lagos Nigeria.
West African Journal of Medicine
|April 3, 2018
Summary
The subvastus surgical approach for total knee replacement significantly reduces postoperative pain compared to the medial parapatellar approach. However, early knee function outcomes were similar between the two surgical methods.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Reconstructive Surgery
Background:
- Total knee replacement (TKR) is a common procedure for arthritic knees.
- Optimizing TKR outcomes is an ongoing area of surgical research.
- Optimal surgical approaches for primary TKR remain debated.
Purpose of the Study:
- To compare the subvastus approach with the medial parapatellar approach for primary total knee arthroplasty.
- To test the hypothesis that the subvastus approach yields superior early functional outcomes.
Main Methods:
- Randomized controlled trial comparing subvastus and medial parapatellar approaches in patients with bilateral knee arthritis.
- Primary outcomes: Knee Society Score (KSS) at 6 weeks, Visual Analogue Score (VAS) for pain on postoperative days 2 and 5.
- Secondary outcomes: Blood loss and transfusion rates.
Main Results:
- The subvastus group reported significantly lower postoperative pain (2.8 vs. 4.62, p < 0.05).
- Blood loss and transfusion requirements were lower in the subvastus group, but not statistically significant.
- No significant difference in Knee Society Score (KSS) at 6 weeks between the groups (80.8 vs. 84.27, p > 0.05).
Conclusions:
- The subvastus approach significantly reduces postoperative pain following total knee replacement.
- Short-term knee function at six weeks is not significantly affected by the choice of surgical approach (subvastus vs. medial parapatellar).
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