Summary

Sub-vastus approach to the knee has superior functional outcome in compare to medial parapetellar approach in first 6 month.

Abstract

Background

Osteoarthritis and rheumatoid arthritis affects all patients of age more than 50 years, requiring total knee replacement. There are two major approaches to total knee replacement- sub-vastus approach and medial parapatellar approach. There is no common consensus on superiority of sub-vastus approach. So, we undertook the present study to evaluate the functional outcome of total knee replacement via sub-vastus approach and medial parapatellar approach in terms of knee Oxford and WAMAC functional scores as patient reported outcome in 3 , 6,12 Month post-operative period.

Methods

The present retrospective cohort study was conducted in the Department of Orthopaedics, Unique Tertiary Speciality Hospital, Makkah, Kingdom of Saudi Arabia for a period from January 2019-May 2022 with sample size of 100 patients undergoing total knee arthroplasty. All the patients had undergone total knee replacement via sub-vastus approach 39 and Medial parapatellar approach 61 patient. The functional Outcome results was compared for significance of deference in patient reported outcome score.

Results

The mean Oxford and WAMAC scores showed a statistically significant improvement over a period of 3,6,12 months (p<0.05), for sub-vastus approach in compare to medial parapatellar approach with use of Mann Whitney and Wilcoxon test for comparison the mean rank score for both Oxford and WAMAC scores.

Conclusions

On comparing the results of sub-vastus approach with medial parapatellar approach the available data from patient reported outcome scores we found a significant improvement in functional outcome with sub-vastus approach in compare with medial parapatellar approach in the first 6month post operatively.
Keywords: Osteoarthritis, Total knee arthroplasty, Sub-vastus approach, medial parapatellar approach, Oxford and WAMAC Knee scores.