Comparing the Sub-Vastus and Medial Parapatellar Approaches in Total Knee Arthroplasty: A Meta-Analysis of Short-Term Outcomes
Proponents of the Sub-Vastus (SV) approach in primary Total Knee Arthroplasty (TKA) claim superior extensor mechanism function which results in earlier recovery after surgery. We performed a meta-analysis of randomized controlled trials comparing the SV and standard Medial Parapatellar (MPP) approac...
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doaj-9d68e6845af7440cb0297606714e8dcc2021-06-01T03:42:36ZengAtlantis PressDr. Sulaiman Al Habib Medical Journal2590-33492021-02-013210.2991/dsahmj.k.210203.001Comparing the Sub-Vastus and Medial Parapatellar Approaches in Total Knee Arthroplasty: A Meta-Analysis of Short-Term OutcomesMohamed SukeikMohammad Zain SohailFahad Siddique HossainSattar AlShrydaJames PowellProponents of the Sub-Vastus (SV) approach in primary Total Knee Arthroplasty (TKA) claim superior extensor mechanism function which results in earlier recovery after surgery. We performed a meta-analysis of randomized controlled trials comparing the SV and standard Medial Parapatellar (MPP) approaches in primary TKAs. The study was performed using the Cochrane handbook for systematic reviews guidelines. A total of 28 studies with 2171 patients were included and the mean age of the SV group was 68.2 [standard deviation, ±4.4] and of the MPP group was 68.4 (±3.85). The SV approach resulted in a significant improvement in flexion at day 3 postoperatively [mean difference (MD) = 6°; 95% confidence interval (CI), 0.37–11.71; p < 0.01], but this was not sustainable at 6 weeks, 3 months, and 12 months postoperatively. Similarly, despite a significant reduction in the visual analogue scale score at day 1 postoperatively (MD = −1.19; 95% CI, −1.70 to −0.68; p < 0.01), there was not enough evidence to support its superiority after that. The SV approach led to a reduction in days to straight leg raise (MD = −1.88; 95% CI, −2.45 to −1.31; p < 0.01) and lateral releases [relative risk = 0.49; 95% CI, 0.30–0.82; p < 0.01) with no difference in complication rates (p = 0.64) but at the expense of a prolonged operation (MD = 13 min; 95% CI, 9.41–16.69; p < 0.01). Our conclusion is that the SV approach provides an alternative to the MPP with some advantages in the first 3 days only after primary TKA surgery.https://www.atlantis-press.com/article/125952603/viewApproachknee arthroplastymedial parapatellarreplacementsub-vastus |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mohamed Sukeik Mohammad Zain Sohail Fahad Siddique Hossain Sattar AlShryda James Powell |
spellingShingle |
Mohamed Sukeik Mohammad Zain Sohail Fahad Siddique Hossain Sattar AlShryda James Powell Comparing the Sub-Vastus and Medial Parapatellar Approaches in Total Knee Arthroplasty: A Meta-Analysis of Short-Term Outcomes Dr. Sulaiman Al Habib Medical Journal Approach knee arthroplasty medial parapatellar replacement sub-vastus |
author_facet |
Mohamed Sukeik Mohammad Zain Sohail Fahad Siddique Hossain Sattar AlShryda James Powell |
author_sort |
Mohamed Sukeik |
title |
Comparing the Sub-Vastus and Medial Parapatellar Approaches in Total Knee Arthroplasty: A Meta-Analysis of Short-Term Outcomes |
title_short |
Comparing the Sub-Vastus and Medial Parapatellar Approaches in Total Knee Arthroplasty: A Meta-Analysis of Short-Term Outcomes |
title_full |
Comparing the Sub-Vastus and Medial Parapatellar Approaches in Total Knee Arthroplasty: A Meta-Analysis of Short-Term Outcomes |
title_fullStr |
Comparing the Sub-Vastus and Medial Parapatellar Approaches in Total Knee Arthroplasty: A Meta-Analysis of Short-Term Outcomes |
title_full_unstemmed |
Comparing the Sub-Vastus and Medial Parapatellar Approaches in Total Knee Arthroplasty: A Meta-Analysis of Short-Term Outcomes |
title_sort |
comparing the sub-vastus and medial parapatellar approaches in total knee arthroplasty: a meta-analysis of short-term outcomes |
publisher |
Atlantis Press |
series |
Dr. Sulaiman Al Habib Medical Journal |
issn |
2590-3349 |
publishDate |
2021-02-01 |
description |
Proponents of the Sub-Vastus (SV) approach in primary Total Knee Arthroplasty (TKA) claim superior extensor mechanism function which results in earlier recovery after surgery. We performed a meta-analysis of randomized controlled trials comparing the SV and standard Medial Parapatellar (MPP) approaches in primary TKAs. The study was performed using the Cochrane handbook for systematic reviews guidelines. A total of 28 studies with 2171 patients were included and the mean age of the SV group was 68.2 [standard deviation, ±4.4] and of the MPP group was 68.4 (±3.85). The SV approach resulted in a significant improvement in flexion at day 3 postoperatively [mean difference (MD) = 6°; 95% confidence interval (CI), 0.37–11.71; p < 0.01], but this was not sustainable at 6 weeks, 3 months, and 12 months postoperatively. Similarly, despite a significant reduction in the visual analogue scale score at day 1 postoperatively (MD = −1.19; 95% CI, −1.70 to −0.68; p < 0.01), there was not enough evidence to support its superiority after that. The SV approach led to a reduction in days to straight leg raise (MD = −1.88; 95% CI, −2.45 to −1.31; p < 0.01) and lateral releases [relative risk = 0.49; 95% CI, 0.30–0.82; p < 0.01) with no difference in complication rates (p = 0.64) but at the expense of a prolonged operation (MD = 13 min; 95% CI, 9.41–16.69; p < 0.01). Our conclusion is that the SV approach provides an alternative to the MPP with some advantages in the first 3 days only after primary TKA surgery. |
topic |
Approach knee arthroplasty medial parapatellar replacement sub-vastus |
url |
https://www.atlantis-press.com/article/125952603/view |
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