International Journal of Orthopaedics Sciences
2018, Volume 4 Issue 4
Medial parapatellar versus subvastus approach in total knee arthroplasty
Author(s): Mr. Raviprasad Kattimani, Dr. Sowmya Sadanandappa, Mr. Chetan M Dojode, Dr. Umesh R Dixit, Mr. Gandavaram Srikant Reddy, Mr. Dhritiman Bhattacharjee, Mr. Amit Sinha
Abstract: Background: Component alignment is one of the most important factors for long term survival after total knee arthroplasty. The medial parapatellar and subvastus are two commonly used surgical approaches in total knee arthroplasty. Methods: The primary aim of this study was to compare component alignment between medial parapatellar and subvastus approach in total knee arthroplasty. The secondary aims were to analyse blood loss, duration of surgery, pain score in post-operative period, length of stay and post-operative complications. A retrospective study was undertaken comparing age and gender matched 60 total knee arthroplasty operated by either medial para patellar (30) or sub vastus approach (30) from January 2009 to December 2010 by two surgeons in a district general hospital, followed up to one year. Revision knee arthroplasty and total knee arthroplasty operated by other surgeons were excluded. Student’s t test and Z test were used for statistics. Results: Subvastus approach had better component alignment in sagittal plane of tibia, coronal plane of femur and tibia (p<0.01). No difference in component alignment at sagittal plane of femur (p>0.05). Pain was better controlled in subvastus approach on post-operative day three (p<0.01). Operative time was more in subvastus group (p<0.05). There were no difference between two groups in duration of stay, blood loss and post-operative complications (p>0.05). Conclusion: Subvastus can be considered as an alternative surgical approach along with standard medial parapatellar approach for primary total knee arthroplasty.