title: Comparison of the minimally invasive and standard medial parapatellar approaches for total knee arthroplasty: systematic review and meta-analysis.
abstract: This systematic literature review analysed the efficacy of minimally invasive subvastus (SV) and midvastus (MV) approaches, compared with the standard medial parapatellar (MP) approach, for total knee arthroplasty. Fixed- and random-effect meta-analyses were performed to pool the results  of primary studies assessing the mean difference of each clinical outcome. Length of hospital stay was significantly different between the MP and SV approaches, but not between the MP and MV approaches. Blood loss was significantly higher following MP compared with SV. The number of days to  perform a straight-leg raise was significantly longer following MP than either MV or SV. In the first 6 months postsurgery, MV was associated with a better range of motion (ROM) than MP. No significant difference in ROM between MP and SV was apparent at 1 year postsurgery. Quadriceps muscle  strength recovered significantly more slowly following MP compared with SV. Future studies should assess the efficacy of the quadriceps-sparing approach and compare minimally invasive approaches, assessing intrinsic postoperative differences.
authors: Orthopaedics Department, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.
authors: Z
authors: Z
authors: Liu
authors: H
authors: H
authors: Yang
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D016063:Blood Loss, Surgical; D005500:Follow-Up Studies; D006801:Humans; D007717:Knee / Q000503:physiopathology / Q000601:surgery*; D007902:Length of Stay; D019060:Minimally Invasive Surgical Procedures; D053580:Muscle Strength; D052097:Quadriceps Muscle / Q000503:physiopathology; D016059:Range of Motion, Articular; D020127:Recovery of Function; D016896:Treatment Outcome