The MSV approach ranked better concerning clinical scores ( the lowest visual analogic scale , the higher KSS and KSFS ) and functional outcomes ( the shortest straight leg raise , the greatest degree of flexion and range of motion ) .
Concerning perioperative data , the MSV evidence d the shortest hospital stay , while the MPP the shortest surgical duration and lowest estimated blood loss .
According to the main findings of the present study , the mini-subvastus approach for total knee arthroplasty demonstrated superior overall compared to the other approaches .
Alternatives to the classical medial parapatellar ( MPP ) approach for total knee arthroplasty ( TKA ) include the mini-medial parapatellar ( MMPP ) , mini-subvastus ( MSV ) , mini-midvastus ( MMV ) and quadriceps-sparing ( QS ) approaches .
The best approach has been not fully clarified .
The purpose of the present study was to conduct a Bayesian network meta- analysis comparing these approaches .
A comparison of subvastus and midvastus approaches in minimally invasive total knee arthroplasty.
BACKGROUND The mini-subvastus and the mini-midvastus approaches are among the most common alternatives to the medial parapatellar approach for total knee arthroplasty . The purpose of this study was to compare the early clinical outcomes of these two approaches . METHODS In this prospect i ve , r and omized study of fifty-one patients who underwent bilateral total knee arthroplasty , the mini-subvastus approach was used in one knee and the mini-midvastus approach , in the contralateral knee . There were forty-two women and nine men who had a mean age of seventy years at the time of the index arthroplasties , and they were followed for two years postoperatively . Clinical outcome was assessed and compared with use of the Knee Society pain and function scores , the straight-leg-raising test , range of motion , and isokinetic strength testing . Operating time and blood loss for each approach were also compared . In addition , patients were surveyed concerning which knee they preferred . RESULTS Comparisons of postoperative Knee Society scores between both approaches at the time of the two-year follow-up did not yield a significant difference in outcome . Isokinetic strength testing at twelve weeks postoperatively revealed no significant differences in muscle strength , with a mean extensor peak torque-to-body weight ratio of 0.14 Nm/kg for both groups . No significant difference was found with respect to total blood loss , straight-leg-raising test , range of motion , or patient preference . There was no clinical ly relevant difference in operative times between the two approaches . CONCLUSIONS The minimally invasive subvastus and midvastus approaches for total knee arthroplasty were both associated with excellent short-term clinical results . Some surgeons believe that the subvastus approach completely avoids damage to the quadriceps mechanism and therefore would be associated with improved muscle function . This prospect i ve series did not identify a substantive difference between the two approaches . We believe that the decision between these surgical approaches should be based on surgeon preference and experience
The MSV approach ranked better concerning clinical scores ( the lowest visual analogic scale , the higher KSS and KSFS ) and functional outcomes ( the shortest straight leg raise , the greatest degree of flexion and range of motion ) .
Concerning perioperative data , the MSV evidence d the shortest hospital stay , while the MPP the shortest surgical duration and lowest estimated blood loss .
According to the main findings of the present study , the mini-subvastus approach for total knee arthroplasty demonstrated superior overall compared to the other approaches .
Alternatives to the classical medial parapatellar ( MPP ) approach for total knee arthroplasty ( TKA ) include the mini-medial parapatellar ( MMPP ) , mini-subvastus ( MSV ) , mini-midvastus ( MMV ) and quadriceps-sparing ( QS ) approaches .
The best approach has been not fully clarified .
The purpose of the present study was to conduct a Bayesian network meta- analysis comparing these approaches .