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A comparative study between Sub-vastus and medial parapatellar approaches in total knee arthroplasty: A prospective
Gaurav Gupta1, Akshay Ramesh Gupta1, Shubham Aggarwal1
1Max Superspeciality Hospital, Mussoorie Diversion Road, Dehradun, 248001, Uttarakhand, India.
Background:
The choice of surgical approach in Total Knee Arthroplasty (TKA) significantly impacts postoperative outcomes. This study compares the Sub-Vastus and Medial Parapatellar approaches in terms of post-operative functional recovery, pain management, and Knee range of motion (ROM).
Methods:
A single-centre prospective comparative study was conducted at Super-speciality Hospital including 100 patients to undergo either the Sub-Vastus (n=50) or Medial Parapatellar (n = 50) approach. Outcomes were assessed using the Knee Society Score (KSS) and Visual Analogue Scale (VAS) and Range of Motion (ROM) at Post Operative Day-1, Post Operative Day-5, Two Weeks,1 Month and 3 Months postoperative intervals. Statistical analyses included the independent t-test and chi-square test, with significance set at p < 0.05.
Results:
The Sub-Vastus group exhibited significantly shorter surgical time (50.08 ± 3.72 min vs. 59.92 ± 4.91 min, p = 0.001) and hospital stay (4.22 ± 0.55 days vs. 5.02 ± 0.80 days, p = 0.001). Functional outcomes, as measured by KSS, were significantly better in the Sub-Vastus group at POD-1, POD-5,1 Week,1 Month and 3 Months period (p = 0.001). Pain scores (VAS) were consistently lower in the Sub-Vastus group from day one to three months postoperatively (p = 0.001). ROM was significantly improved in the Sub-Vastus group, with a greater proportion of patients achieving higher degrees of flexion at each follow-up interval (p < 0.05).
Conclusion:
The Sub-Vastus approach in TKA results in superior early functional recovery, reduced pain, and enhanced ROM compared to the Medial Parapatellar approach. While both techniques yield comparable outcomes at three months, the Sub-Vastus approach may be preferred for patients prioritizing early rehabilitation. Future studies with extended follow-up are needed to evaluate long-term complications and sustained benefits.
