title: Sub-vastus approach is more effective than a medial parapatellar approach in primary total knee arthroplasty: a randomized controlled trial.
abstract: In a prospective single-centre longitudinal randomized controlled trial 116 patients were allocated to the sub-vastus approach, and 115 to the medial parapatellar approach. At one week follow-up, compared to baseline, range of motion, Knee Society (KS) global, KS knee, and KS pain scores were significantly better in the sub-vastus group. At the one year follow-up, WOMAC global and pain scores, SF36 physical function and role-physical scores, and EuroQol utility and pain score were significantly better in the sub-vastus group. The ease of exposure in the sub-vastus approach was significantly worse. There was no significant difference in length of stay or analgesia intake. The sub-vastus approach to total knee arthroplasty was more effective than a medial parapatellar approach at both one week and one year post-operatively, but surgeons reported a less easy exposure in the sub-vastus group.
authors.affiliation: Keele University Medical School, Department of Trauma and Orthopaedic Surgery, Orthopaedic Surgical Trial Unit, Stoke-on-Trent, England, United Kingdom.
authors.forename: Stephen A
authors.initials: SA
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
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery; D008297:Male; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000601:surgery*; D010147:Pain Measurement; D010329:Patella / Q000601:surgery*; D011446:Prospective Studies; D052097:Quadriceps Muscle / Q000601:surgery*; D011788:Quality of Life; D016059:Range of Motion, Articular; D016896:Treatment Outcome