Saudi Journal of Medicine and Medical Sciences (Jan 2024)

Functional Outcome of Subvastus versus Medial Parapatellar Approaches for Total Knee Replacement in Patients with Knee Osteoarthritis: A Prospective Cohort Study

  • Adnan Ahmed Aladraii,
  • Lama Zaki Allehaibi,
  • Amjad Abdulrahman Fattani,
  • Taif Abdullah Alkhudairy,
  • Albatoul Mohammed Al-Margan,
  • Sami Abdo Radman Al-Dubai,
  • Abdulrahman Abdulraof Mohammed,
  • Doaa K Mohorjy,
  • Abdulhakeem Saeed Alqarni

DOI
https://doi.org/10.4103/sjmms.sjmms_237_23
Journal volume & issue
Vol. 12, no. 1
pp. 35 – 39

Abstract

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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.

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