Title: Functional Outcome of Subvastus versus Medial Parapatellar Approaches for Total Knee Replacement in Patients with Knee Osteoarthritis: A Prospective Cohort Study
Background: Subvastus approach and medial parapatellar approach are two major approaches for total knee replacement (TKR). There is no global consensus on the superiority of either approach in terms of functional outcomes. Objective: The present study aimed to evaluate the functional outcome of TKR through subvastus approach and medial parapatellar approach by using patient-reported scores at 3-, 6-, and 12-month post-operative follow-ups.
Methods: This prospective cohort follow-up study included patients with knee osteoarthritis who underwent elective primary TKR either through the subvastus or medial parapatellar approaches at King Abdullah Medical City, Makkah city, Kingdom of Saudi Arabia, from January 2019 to December 2022. Scores from the self-reported Oxford Knee Score (OKS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were compared in the two groups of patients at 3-, 6-, and 12-month post-operative follow-ups.
Results: A total of 98 patients were included, of which 37 underwent TKR through the subvastus approach and 61 through the medial parapatellar approach. There was an overall significant change over time in both WOMAC and OKS scores (P < 0.001). Patients who underwent the subvastus approach had significantly higher mean of WOMAC and OKS than patients with the medial parapatellar approach at the 3- and 6-month follow-ups (P < 0.05), but not at the 12-month follow-up.
Conclusions: For TKR, the medial parapatellar approach results in better functional outcomes at the 3- and 6- month follow-up periods compared with the subvastus approach.
Adnan Aladraii was born on November 11, 1981, in the Yemen. Graduated from UKM university in Malaysia and had Malaysian board of Orthopaedics and traumatology, Had MRCS, FRCS Ortho, Traumatology from RCSE in UK. Had Arthroplasty fellowship from istiyne university Istanbul, and Ortho one center India, and had Trauma fellowship from Charite hospital berlin. His curiosity led him get several fellowships and to excelled academically and clinical and has several research in Orthopaedics.