Approach to Total Knee Replacement: A Randomized Double Blind Study between Medial Parapatellar and Midvastus Approach in the Early Postoperative Period in Asian Population

Mohammed Ammar Aslam; Aamir Bin Sabir; Vivek Tiwari; Sohail Abbas; Anurag Tiwari; Pritish Singh

doi:10.1055/s-0036-1597978

The Journal of Knee Surgery, Table of Contents

J Knee Surg 2017; 30(08): 793-797
DOI: 10.1055/s-0036-1597978

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Approach to Total Knee Replacement: A Randomized Double Blind Study between Medial Parapatellar and Midvastus Approach in the Early Postoperative Period in Asian Population

Mohammed Ammar Aslam

¹Department of Orthopaedics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India

,

Aamir Bin Sabir

²Department of Orthopaedic Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India

,

Vivek Tiwari

¹Department of Orthopaedics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India

,

Sohail Abbas

¹Department of Orthopaedics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India

,

Anurag Tiwari

¹Department of Orthopaedics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India

,

Pritish Singh

¹Department of Orthopaedics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India

› Author Affiliations

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.

Keywords

midvastus - medial parapatellar - total knee replacement - approach - Knee Society score

Full Text

References

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