Dr. Balasubramanian Santharam
BACKGROUND Among the various surgical approaches for total knee arthroplasty, medial parapatellar and subvastus approach are two commonly used surgical approaches in total knee arthroplasty. The aim of this study is to compare the functional outcome between subvastus approach and medial parapatellar approach. METHODS This is a prospective study which compared medial parapatellar approach (Group-1, 30 patients) and subvastus approach (Group-2, 30 patients) from November 2017 to March 2019, in Rajarajeswari Medical College and Hospital, Bangalore. Patients were followed up for 16 months. Revision knee arthroplasty cases and total knee arthroplasty cases operated by other surgeons were excluded. RESULTS There was no significant difference between subvastus approach and medial parapatellar approach. Except that in subvastus approach, quadriceps tendon was not disrupted. Pain was better controlled in subvastus approach on post-operative day but operative time was more in subvastus group. There were no difference between two groups with regard to duration of stay, blood loss and post-operative complications. CONCLUSIONS Subvastus approach provided better pain relief postoperatively, but operative time was more in subvastus group. There was no significant difference between the two groups in duration of stay and post-operative complications. Subvastus can also be considered as an alternative surgical approach along with standard medial parapatellar approach for primary total knee arthroplasty.
