title: Approach to Total Knee Replacement: A Randomized Double Blind Study between Medial Parapatellar and Midvastus Approach in the Early Postoperative Period in Asian Population.
abstract: The purpose of this randomized study was to compare clinical and surgical outcomes of total knee replacements (TKRs) in the early postoperative period using midvastus approach versus medial parapatellar approach in Asian population in a double blind manner. Forty-two knees each were operated using midvastus approach and the medial parapatellar approach. Clinical parameters that were evaluated included Knee Society score (KSS); knee pain using visual analogue scale (VAS) on day 1, 1 week, and 1 month; time required to straight leg raise (SLR); patellar tracking; mean extensor lag at 1 week and 1 month; and time of discharge from the hospital. Surgical parameters that were evaluated included tourniquet time, incidence of lateral retinacular release, estimated blood loss, and any complications during the surgery. KSS at 1 week and 1 month postoperatively were significantly higher in the midvastus group as compared with medial parapatellar group; though similar at 3 months, 6 months, and 1 year. The patients in midvastus group required fewer number of lateral retinacular releases; achieved SLR earlier; had less mean extensor lag at 1 week; had less mean VAS score at day 1, 1 week, and 1 month; and had shorter hospital stay. There was no significant difference in the mean tourniquet time and estimated blood loss. One patient had patellar maltracking in the medial parapatellar group as compared with none in midvastus group. Midvastus approach to TKR results in quicker functional recovery with early discharge and rehabilitation in the Asian population as compared with medial parapatellar approach.
authors.affiliation: Department of Orthopaedics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India.
authors.forename: Mohammed Ammar
authors.initials: MA
authors.lastname: Aslam
authors.affiliation: Department of Orthopaedic Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
authors.forename: Aamir Bin
authors.initials: AB
authors.lastname: Sabir
authors.affiliation: Department of Orthopaedics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India.
authors.forename: Vivek
authors.initials: V
authors.lastname: Tiwari
authors.affiliation: Department of Orthopaedics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India.
authors.forename: Sohail
authors.initials: S
authors.lastname: Abbas
authors.affiliation: Department of Orthopaedics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India.
authors.forename: Anurag
authors.initials: A
authors.lastname: Tiwari
authors.affiliation: Department of Orthopaedics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India.
authors.forename: Pritish
authors.initials: P
authors.lastname: Singh
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D044466:Asian People; D016063:Blood Loss, Surgical; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D020370:Osteoarthritis, Knee / Q000601:surgery; D020127:Recovery of Function; D064232:Visual Analog Scale