Less pain found with subvastus vs. parapatellar TKA approach


Less pain found with subvastus vs. parapatellar TKA approach 

Curtin B. J Arthrop. 2014;doi: 10.1016/j.arth.2013.03.021 

According to researchers of this study, total knee arthroplasty performed with a subvastus approach yield better outcomes for pain at 6-months and 1-year postoperatively compared to procedures performed with the standard parapatellar method.
“We feel that a subvastus approach minimizes trauma to the extensor mechanism, and therefore decreases the incidence of postoperative pain following [total knee arthroplasty] TKA,” Brian Curtin, MD, and colleagues wrote in their study.
Curtin and his team performed a retrospective study of 546 patients who underwent TKA with a parapatellar approach (Group A) and 255 patients who underwent TKA with a subvastus approach (Group B). Osteoarthritis was the primary preoperative diagnosis in all but four cases in the study.
The preoperative Knee Society Scores (KSS) were 53.8 for Group A and 51.5 for Group B. The KSS was 83.9 and 78.1, respectively, at 6 weeks postoperatively and 87.5 and 93.2, respectively, at 1-year follow-up. Although the preoperative pain values were comparable between groups, Group A had a pain value of 38.8 at 6 weeks postoperatively compared to 46.2 for Group B. The 1-year postoperative values for pain were 41.7 for Group A and 49.3 for Group B, according to the study.
The investigators discovered comparable operating room time, blood loss, tourniquet time, length of hospital stay and number of manipulations between the groups.
Although previous studies conducted on this subject had been unable to pinpoint significant differences in KSS between these approaches, Curtin’s group credited the larger size of their study for bringing the statistically significant differences to light. – by Christian Ingram
Disclosures: The authors had no relevant financial disclosures.

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