Comparison of Subvastus and Medial Parapatellar Approaches in Primary Total Knee Arthroplasty in Term of Clinical Outcome

Background & objectives: The purpose of this study was to determine differences in clinical outcomes between subvastus and medial parapatellar approach in primary total knee arthroplasty. Methods: This is a prospective randomized study; we compared the clinical results of primary total knee...

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Main Authors: Soran Ibrahim Abdalrahman, Ali Abdalnabi Alwan Al-Tamimi, Areewan Muhamadsalh Saeed
Format: Article
Language:English
Published: Kurdistan Higher Council Of Medical Specialties 2022-06-01
Series:Advanced Medical Journal
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Online Access:https://amj.khcms.edu.krd/index.php/main/article/view/31
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author Soran Ibrahim Abdalrahman
Ali Abdalnabi Alwan Al-Tamimi
Areewan Muhamadsalh Saeed
author_facet Soran Ibrahim Abdalrahman
Ali Abdalnabi Alwan Al-Tamimi
Areewan Muhamadsalh Saeed
author_sort Soran Ibrahim Abdalrahman
collection DOAJ
description Background & objectives: The purpose of this study was to determine differences in clinical outcomes between subvastus and medial parapatellar approach in primary total knee arthroplasty. Methods: This is a prospective randomized study; we compared the clinical results of primary total knee arthroplasty using Subvastus and medial Parapatellar approaches in 34 patients. The standard medial Parapatellar approach was used in 19 patients and Subvastus approach was used in 15 patients. The clinical outcome was assessed using a knee society score, time to return quadriceps function, and visual analog scale for pain. Results: The mean follow-up time was 3 months. Pain improved significantly over time in both groups. However, when comparing groups together, patients in subvastus group had better numerical visual analogue scale scores at 3rd day postoperatively, nevertheless, no significant differences were found at other follow up times (8.11, 6.05, 4.26, 2.32, 1.47 for medial parapatellar group and 8.20, 4.47, 4.0, 1.67, 1.07 for subvastus group at preoperative, 3rd day, 2, 6 and 12 weeks postoperative respectively for both groups). Subvastus roup had earlier return of quadriceps function by 1.9 days which was significant statistically. Knee society score improved significantly over time without any significant differences when comparing both groups together at any time of the follow-up periods (, 66.42, 105.21, 137.63, 155.53 for the medial parapatellar group and, 62.53, 107.53, 137.6, 155.81 for subvastus group at preoperative, 2, 6 and 12 weeks postoperative respectively for both groups). Conclusions: Subvastus approach allowed the earlier return of quadriceps function and less pain in the early postoperative day. In terms of physical and functional outcomes, none of the two surgical approaches showed an advantage over the other.
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spelling doaj-art-818590cec4b9490c98935eba107a42182025-08-20T02:11:47ZengKurdistan Higher Council Of Medical SpecialtiesAdvanced Medical Journal2958-89792957-35802022-06-016210.56056/amj.2022.14831Comparison of Subvastus and Medial Parapatellar Approaches in Primary Total Knee Arthroplasty in Term of Clinical OutcomeSoran Ibrahim Abdalrahman0Ali Abdalnabi Alwan Al-Tamimi1Areewan Muhamadsalh Saeed2KBMS trainee/ Ortho. Department of orthopedic surgery; Shar teaching Hospital; Kurdistan/ Assistant professor of orthopedic surgery, College of medicine, University of Sulaimani; Consultant orthopedic surgeon; Sulaimani teaching Hospital; Kurdistan/ IraqLecturer, Department of orthopedic surgery, college of medicine, University of Sulaimani, Sulaimani, Kurdistan region/ Iraq Background & objectives: The purpose of this study was to determine differences in clinical outcomes between subvastus and medial parapatellar approach in primary total knee arthroplasty. Methods: This is a prospective randomized study; we compared the clinical results of primary total knee arthroplasty using Subvastus and medial Parapatellar approaches in 34 patients. The standard medial Parapatellar approach was used in 19 patients and Subvastus approach was used in 15 patients. The clinical outcome was assessed using a knee society score, time to return quadriceps function, and visual analog scale for pain. Results: The mean follow-up time was 3 months. Pain improved significantly over time in both groups. However, when comparing groups together, patients in subvastus group had better numerical visual analogue scale scores at 3rd day postoperatively, nevertheless, no significant differences were found at other follow up times (8.11, 6.05, 4.26, 2.32, 1.47 for medial parapatellar group and 8.20, 4.47, 4.0, 1.67, 1.07 for subvastus group at preoperative, 3rd day, 2, 6 and 12 weeks postoperative respectively for both groups). Subvastus roup had earlier return of quadriceps function by 1.9 days which was significant statistically. Knee society score improved significantly over time without any significant differences when comparing both groups together at any time of the follow-up periods (, 66.42, 105.21, 137.63, 155.53 for the medial parapatellar group and, 62.53, 107.53, 137.6, 155.81 for subvastus group at preoperative, 2, 6 and 12 weeks postoperative respectively for both groups). Conclusions: Subvastus approach allowed the earlier return of quadriceps function and less pain in the early postoperative day. In terms of physical and functional outcomes, none of the two surgical approaches showed an advantage over the other. https://amj.khcms.edu.krd/index.php/main/article/view/31Total knee arthroplastySurgical approachKnee society scoreReplacement
spellingShingle Soran Ibrahim Abdalrahman
Ali Abdalnabi Alwan Al-Tamimi
Areewan Muhamadsalh Saeed
Comparison of Subvastus and Medial Parapatellar Approaches in Primary Total Knee Arthroplasty in Term of Clinical Outcome
Advanced Medical Journal
Total knee arthroplasty
Surgical approach
Knee society score
Replacement
title Comparison of Subvastus and Medial Parapatellar Approaches in Primary Total Knee Arthroplasty in Term of Clinical Outcome
title_full Comparison of Subvastus and Medial Parapatellar Approaches in Primary Total Knee Arthroplasty in Term of Clinical Outcome
title_fullStr Comparison of Subvastus and Medial Parapatellar Approaches in Primary Total Knee Arthroplasty in Term of Clinical Outcome
title_full_unstemmed Comparison of Subvastus and Medial Parapatellar Approaches in Primary Total Knee Arthroplasty in Term of Clinical Outcome
title_short Comparison of Subvastus and Medial Parapatellar Approaches in Primary Total Knee Arthroplasty in Term of Clinical Outcome
title_sort comparison of subvastus and medial parapatellar approaches in primary total knee arthroplasty in term of clinical outcome
topic Total knee arthroplasty
Surgical approach
Knee society score
Replacement
url https://amj.khcms.edu.krd/index.php/main/article/view/31
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