2020, Vol. 4 Issue 1, Part B
Background: Minimally invasive subvastus approach preserves the quadriceps extenser mechanism, reduces postoperative pain, provides early mobilization and helps in faster recovery. Our randomized controlled study presents the early functional results of minimally invasive subvastus approach in primary total knee arthroplasty (TKA).
Materials and Methods: Primary TKA procedures were done in 50 patients via minimally invasive subvastus approach and in another 50 patients via medial parapatellar approach, randomly. The postoperative clinical evaluation was done at day 0, 1, 3 and at discharge. All categorical variables were analysed by the null hypotheses of no differences in patients treated with either group at 95% significance level (P –value < 0.05).
Results: In subvastus group, the average length of cutaneous incision was shorter and less perioperative blood loss as compared to the medial parapatellar group. The average surgical time was significantly more in subvastus group. The VAS scores were significantly lower in subvastus group at day 1 and day 3. Time to straight leg raise, ability to use commode chair, and stairs climbing were significantly earlier (P- value< 0.05) in subvastus group. The average hospital stay was 2.24 days shorter in subvastus group.
Conclusion: With a learning curve, minimally invasive subvastus approach produces significantly less pain, early rehabilitation, and shorter hospital stay, without increase in the overall complication rate.