Publication:

Comparative study with 2 years follow up on the functional outcome of subvastus versus medial parapatellar approach in total knee arthroplasty in a tertiary care center in South India

Background There are many approaches while performing a total knee arthroplasty, with the medial parapatellar and the subvastus approaches being the more common among surgeons. While there are many studies comparing both the approaches, there is a lacuna regarding their long term functional outcome in the Indian population.  The study aimed to evaluate the functional outcome of TKA through subvastus approach and medial parapatellar approach by using the knee society score, at postoperative day 5, 2 weeks, 6 weeks, 3 months, 6 months, 12 months and 24 months postoperatively.

Methods This randomized controlled prospective study included patients with advanced knee osteoarthritis who underwent elective primary TKA either through the subvastus or medial parapatellar approaches at a tertiary care center in South India from January 2021 to December 2024 .Knee Society Scores were compared in the two groups of patients on postoperative day 5, 2 weeks, 6 weeks, 3 months, 6 months, 12 months and 24 months postoperatively.

Results 300 people were included in the study of which, of which 150 of them underwent a TKA via a medial parapatellar approach and the rest via the subvastus approach. There was an overall significant change over time in KSS scores but the results were comparable between the two groups. The subvastus group showed significantly quicker return of quadriceps function and shorter hospital stays. The medial parapatellar group has the shorter surgical time.

Conclusions Both approaches are comparable in terms of functional outcome, with the subvastus approach showing a longer surgical duration but a quicker return of quadriceps function and shorter hospital stay.