Evaluation of Clinical and Radiological Outcomes of Subvastus and Medial Parapatellar Approaches in Total Knee Arthroplasty

Objective: The aim of this study is to compare clinically and radiologically the subvatus (SV) and medial parapatellar (MPP) approaches performed in patients undergoing total knee arthroplasty (TKA) due to severe gonarthrosis. Method: Patients who underwent TKA between 2015 and 2019 were divided into two groups as SV and MPP, according to the type of approach performed. Demographic, clinical, and surgical information of the patients were evaluated. Knee Society Clinical Rating System (KSS) and visual analogue scale (VAS) scores were used for functional evaluation. AP and lateral orthoroentgenograms and knee radiographs taken at the last follow-up were used for radiological evaluation. Results: The mean duration of surgery and tourniquet was significantly higher in the SV group. (p <.001 and p <.001, respectively). Mean blood loss and number of blood transfusions were significantly higher in the MPP group. (p <.001 and p <.001, respectively). Opiate analgesic need, straight leg raising time and hospitalization time were also significantly higher in the MPP group. (p <.001, p <.001 and p <.001, respectively). Although the KSS, VAS scores, and the range of motion (ROM) at the first month were better in the SV group, there was no difference between the two groups at 6 and 12 months. Conclusion: According to this study, with the SV approach used for TKA, postoperative blood loss and the need for transfusion decreased, the duration of hospitalization was shortened, postoperative pain was less, and functional scores were better. Its only disadvantage was the prolonged operation time.