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 .
The effectiveness of minimally invasive total knee arthroplasty to preserve quadriceps strength: a randomized controlled trial.
We performed a single-center , r and omized , double-blind study to compare muscle strength in patients who had undergone primary total knee arthroplasty ( TKA ) , performed using either a minimally invasive or a conventional surgical technique . We evaluated 30 knees in healthy age-matched subjects , 22 knees after conventional TKA ( conventional group ) , and 23 knees after minimally invasive surgery TKA ( MIS group ) .  The Hospital for Special Surgery ( HSS ) score , Oxford knee score ( OKS ) , and isokinetic ( 60º/s ) muscle strength were evaluated the day before surgery and 3 , 6 , and 12 months after surgery . HSS and OKS improved significantly over time during follow-up ( p<0.001 ) , but there was no significant difference between the groups ( p>0.05 ) . The extensor peak torque ( EPT ) and flexor peak torque ( FPT ) improved significantly over time ( p<0.001 ) and EPT was greater in the MIS group than in the conventional group during the follow-up period ( p<0.05 ) . There was no difference in FPT and the hamstring-to-quadriceps ratio between the groups . Although MIS patients had a significant deficit in extensor strength following TKA , compared with healthy controls , this approach offers a significant improvement in extensor muscle strength over conventional surgery . These results suggest that the MIS approach results in better outcomes with regard to maintaining extensor strength than the conventional surgical approach
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 .