Comparison of effects of medial parapatellar and subvastus bilateral simultaneous approaches in total knee arthroplasty

Background

Total knee arthroplasty is the prevalent surgical intervention being used to treat knee osteoarthritis. Although the medial parapatellar approach is the prominent surgical approach, the parapatellar incision has concerning theoretical risks. The subvastus approach is a less invasive, but less commonly used alternative. The aim of this study is to compare the post-operative outcomes of these two surgical approaches with respect to retropatellar knee pain, knee range of motion, and quadriceps muscle strength at 6 and 12 months post-operation.

Methods

In this randomized controlled trial, 50 patients who suffered from advanced osteoarthritis in both knees underwent simultaneous bilateral total knee arthroplasty, one using the medial parapatellar approach and the other using the subvastus approach. Retropatellar knee pain, quadriceps muscle strength and knee range of motion were assessed pre-operation, as well as at 6 and 12 months post-operation.

Results

This study found no statistically significant differences in retropatellar knee pain, quadriceps muscle strength, or knee range of motion between the medial parapatellar and subvastus approaches at 6 and 12 months post-operation.

Conclusion

The results of this study provide further evidence that the subvastus approach is a comparable alternative to the medial parapatellar approach, but do not indicate any advantages to one over the other. More research is necessary in order to determine if there is an added benefit to the subvastus approach in the short term (<3 months).