Does Surgical Approach Actually Affect the Functional Outcomes of Total Knee Arthroplasty Patients?

Background and Purpose: Medial parapatellar (MPA) and sub-vastus (SV) are two common approaches used for total knee arthroplasty (TKA). Till date, many studies on the comparison of outcomes of both approaches have been conducted, but none are able to prove the superiority of either of the approaches. The aim of the present study is to evaluate the functional outcome of TKA by comparing the MPA and SV approaches at our institute. Materials and Methods: This prospective study included patients with knee osteoarthritis based on clinico-radiological diagnosis who underwent TKA at VIROC Super Specialty Hospital, Vadodara, Gujarat, India, from January 1, 2024, to June 30, 2024. The scores taken into consideration from outcome measures are visual analog scale (VAS) (at Day 0/1/2, 1/3/6 months), Oxford knee scores (OKS), and knee society scores (KSS) taken at the 1 st , 3 rd , 6 th , and 12 th months postoperatively. Results: A total of 60 patients were included in the study. Two Groups A and B, were divided randomly. In each group, 30 patients were taken into consideration, and the ratio of males to females was equal in both groups. The mean age of Groups A and B was 65.13 ± 9.23 and 69.43 ± 8.36 years. The patients of Group A (MPA) had higher OKS scores in comparison to Group B (SV) at the 3 rd and 6 th month (39.7 ± 2.52 and 38.1 ± 2.32, P = 0.01, 42.33 ± 2 and 40.73 ± 3.35, P = 0.048) and similar OKS scores at the 12 th month (44.9 ± 1.62 and 44.83 ± 1.44). The Group A (MPA) had higher KSS scores in comparison to Group B (SV) 6 th and 12 th months (82.93 ± 4.55 and 80.16 ± 4.97, P = 0.029, 91.26 ± 4.33 and 88.63 ± 4.20, P = 0.020). The KFS ( P > 0.05) shows no significant difference on 3 rd , 6 th and 12 th months. The VAS score ( P > 0.05) shows no significant difference on postoperative day 0, 1, 2, 1 st , and 3 rd months in both Group A and Group B. In the study, three patients had superficial infections (Group A [2] and Group B [1]) and were managed with debridement and antibiotics. Conclusion: For TKA, functional outcomes were better with the MPA approach in comparison to the SV approach during the 3 rd and 6 th months of duration. At the 12 th month, the outcomes of both approaches were similar.