Parapatellar versus subvastus approach to the knee in total knee arthroplasty
A retrospective, randomized and single-blind study
Abstract
Introduction: the medial parapatellar is the most widely used approach in the standard method of total knee arthroplasty. However, recent studies have reported better results regarding functional recovery when the subvastus approach is used.
Objective: to evaluate early functional results of both surgical approaches to knee arthroplasty, testing the hypothesis that the subvastus approach is significantly better than the medial parapatellar approach in thin patients.
Method: a retrospective, randomized and blind study of 44 consecutive primary knee arthroplasties, comparing two approaches: medial parapatellar versus subvastus approach. The patients received the same prosthesis (Sigma Johnson), and the same surgeon operated them using the exact same technique, though a different approach was used - as already mentioned. The parapatellar approach was used in 22 patients, while the remaining 22 patients were operated through the subvastus approach.
Patients were assessed upon three days, and one, three and six months after surgery.
Results: the groups were compared through the student t-test for independent variables and chi-square, and predictors for late extension were set by means of multiple linear regression.
Conclusions: we managed to conclude that the subvastus approach is more convenient since it favors bending the knee in the short term, although differences tend to disappear after three months.
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