title: Sub-vastus approach versus the medial parapatellar approach in primary total knee: a randomised controlled trial [ISRCTN44544446].
abstract: BACKGROUND
  Thirty thousand knee replacements are performed annually in the UK. There is uncertainty as to the best surgical approach to the knee joint for knee arthroplasty. We planned a randomised controlled trial to compare a standard medial parapatellar arthrotomy with sub-vastus arthrotomy for patients undergoing primary total knee arthroplasty in terms of short and long term knee function.
  
  
  METHODS
  Patients undergoing primary total knee arthroplasty at the local NHS Trust are to be recruited into the study. Patients are to be randomised into either the sub-vastus or medial parapatellar approach to knee arthroplasty. The primary outcome measures will be the American Knee Society and WOMAC Scores. The secondary outcome measures will be patient based measures of EuroQol and SF-36. All outcomes will be measured pre-operatively, 1, 6, 12 and 52 weeks post-operatively. We will also review pain intensity using a pain and analgesia diary. Ease of surgical exposure and complications will also be analysed.
  
  
  CONCLUSIONS
  Evidence is lacking concerning the best surgical approach to the knee joint for patients undergoing primary total knee replacement. This pragmatic randomised trial tests the hypothesis that the sub-vastus approach is significantly superior to the standard medial parapatellar approach in terms of short and long term knee function.
authors.affiliation: University of Keele, Keele University Medical School, Thornburrow Drive, Hartshill, Stoke-on-Trent, Staffordshire, ST4 7QB, UK. stephen.bridgman@newcastle-ul-pct.nhs.uk
authors.forename: Stephen
authors.initials: S
authors.lastname: Bridgman
authors.forename: Gayle
authors.initials: G
authors.lastname: Walley
authors.forename: Gilbert
authors.initials: G
authors.lastname: MacKenzie
authors.forename: Darren
authors.initials: D
authors.lastname: Clement
authors.forename: David
authors.initials: D
authors.lastname: Griffiths
authors.forename: Nicola
authors.initials: N
authors.lastname: Maffulli