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 .
Quadriceps-sparing versus Mini-subvastus Approach in Total Knee Arthroplasty
In a prospect i ve r and omized double-blind study we compared the postoperative recovery and early results of two groups of 30 patients having total knee arthroplasty with minimally invasive techniques using either a mini-subvastus or a modified “ quadriceps-sparing ” approach .  All knees were implanted with the same posterior-stabilized prosthesis ( LPS-Flex , Zimmer , Warsaw , IN ) by the same surgeon with the same dedicated set of downsized instruments . Epidural anesthesia with the same postoperative analgesia and rehabilitation protocol was used in all patients . Evaluation was performed preoperatively , postoperatively in the first week , and at 1 and 3 months . In five cases in the “ quadriceps- sparing ” group , the incision was extended a few cm to facilitate exposure . Tourniquet time , estimated blood loss , and postoperative pain were similar in the two groups . Active straight leg raising was achieved half a day earlier , on average , in the mini-subvastus group ( 1.9 vs 1.4 days ) . Average maximum active flexion was similar in the two groups at each interval , and reached 117 ° and 119 ° at 3 months for the mini-subvastus and “ quadriceps-sparing ” group , respectively . We believe there was no difference between the mini- subvastus and “ quadriceps-sparing ” approach in relation to short term recovery or early results . Level of Evidence : Level I , therapeutic study . See Guidelines for Authors for a complete description of levels of evidence
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 .