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 .
Better quadriceps recovery after minimally invasive total knee arthroplasty
Purpose The proponents of  minimally invasive total knee arthroplasty ( TKA )  have reported better functional recovery than conventional TKA . In most of the previous studies , the results were shown with the relatively subjective methods . We investigated the objective results with a dynamometry in this prospect i ve r and omized study . It was hypothesized that minimally invasive TKA would have a better and earlier recovery of quadriceps force in terms of the objective numeric data . Methods Sixty-six TKAs were prospect ively r and omized into two groups . Thirty-three knees underwent minimally invasive TKA using mini-midvastus approach and 33 knees underwent conventional TKA using medial parapatellar approach .  The quadriceps force was assessed using a dynamometer . The data were collected preoperatively and at postoperative 6 weeks , 3 months , 6 months and 1 year consecutively . Results The mean of quadriceps force in minimally invasive TKA group at postoperative 6 weeks was greater than conventional TKA after removing the covariate ( preoperative quadriceps force ) with analysis of covariance ( P = 0.002 ) , but thereafter , the difference was not significant till 1 year . Meanwhile , with repeated measures analysis of variance , conventional TKA group had greater quadriceps recovery than minimally invasive TKA group during postoperative 6 weeks to 3 months ( P = 0.035 ) . The proportion of patients unable to recover the quadriceps force to their preoperative levels by 1 year postoperatively was similar in two groups . Conclusion Minimally invasive TKA has benefit in quadriceps recovery at earlier rehabilitation period although catch-up recovery in conventional TKA was accelerated from the postoperative 6 weeks to 3 months . It may support the concept of early return to full activity after minimally invasive TKA , and patients might get back early to normal life . Level of evidence Therapeutic study , Level
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 .