• Arch Orthop Trauma Surg · Nov 2024

    Comparative Study

    Comparison of early outcomes of primary total knee arthroplasties performed using subvastus and medial parapatellar approaches and evaluation of quadriceps muscle elastography.

    • Mehmet Fatih Güven, Mete Özer, Mahmut Kürşat Özşahin, Göker Utku Değer, İbrahim Adaletli, Osman Aykan Kargin, Gökhan Kaynak, and Hüseyin Botanlıoğlu.
    • Department of Orthopaedics and Traumatology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Cerrahpaşa Tıp Fakültesi Yerleşkesi Kocamustafapaşa Caddesi No:53 Cerrahpaşa , Fatih, İstanbul, 34098, Turkey.
    • Arch Orthop Trauma Surg. 2024 Nov 1; 144 (11): 483948474839-4847.

    BackgroundIn primary total knee arthroplasty (TKA) surgeries, the medial parapatellar (MP) and subvastus (SV) approaches are frequently employed. The SV approach involves preserving the vastus medialis muscle, leading to debates about the possibility of earlier healing of the extensor mechanism. Shear wave elastography (SWE) is known for monitoring tissue healing. In this study, our research question revolves around whether there exist differences in tissue healing following MP and SV approaches. Unlike previous studies, we aim to investigate this difference using solely SWE, which provides a quantitative measurement specifically targeting the vastus medialis muscle.MethodsWe divided 17 patients into two groups: SV (10 patients) and MP (7 patients). SWE measurements and clinical scores were recorded before surgery and at the 3rd-month follow-up. The first straight leg raising days were also recorded.ResultsBoth the MP and SV groups showed significant improvement in clinical scores postoperatively. Straight leg raising time was comparatively earlier in the SV group, but no significant difference was found. SWE measurements revealed similar recovery values in the vastus medialis muscle between the two groups.ConclusionBoth MP and SV approaches demonstrate similar and favorable early outcomes in TKA surgery. The preservation of the vastus medialis in the SV approach does not lead to significant differences in clinical scores or muscle recovery compared to the MP approach.Trial RegistrationThe study was retrospectively registered on ClinicalTrials.gov on March 7, 2024 (NCT06297746). https://classic.Clinicaltrialsgov/ct2/show/NCT06297746?id=am7mi3VB&draw=2&rank=1 .© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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