PT  - JOURNAL ARTICLE
AU  - Sahil Prabhnoor Sidhu
AU  - Lyndsay E. Somerville
AU  - Aamir Sohail Sidhu
AU  - Ryan T. Willing
AU  - Matthew G. Teeter
AU  - Brent A. Lanting
TI  - Does surgical approach affect patient outcomes of total knee arthroplasty?
AID  - 10.1503/cjs.010920
DP  - 2021 Oct 01
TA  - Canadian Journal of Surgery
PG  - E521--E526
VI  - 64
IP  - 5
4099  - http://canjsurg.ca/content/64/5/E521.short
4100  - http://canjsurg.ca/content/64/5/E521.full
SO  - CAN J SURG2021 Oct 01; 64
AB  - Background: Surgical approaches for total knee arthroplasty (TKA) include the medial parapatellar (MPA), subvastus (SV), midvastus (MV), and lateral parapatellar approach (LPA); it remains unclear which approach is superior.Methods: Patients having undergone TKA at our institution were retrospectively organized into matched groups according to surgical approach (MPA, MV, SV, or LPA). Outcomes between the groups were compared using the Short-Form 12 (SF-12), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Society Score (KSS), and range of motion (ROM) up to 2 years postoperative.Results: Sixty-eight MV patients, 8 SV patients, and 4 LPA patients were matched with groups of MPA patients. There was no difference in outcomes between the MPA and MV groups up to 2 years. The SV group had significantly higher SF-12 Physical Composite Score (PCS; p = 0.036) and WOMAC stiffness score (p = 0.014) at 2 years, but significantly lower flexion at 1 year (p = 0.022) than the MPA group. The LPA group had significantly lower SF-12 PCS (p = 0.011) and WOMAC function scores (p = 0.022) at 1 year than the MPA group.Conclusion: There was no significant difference between the MPA and MV approach. The SV approach had some improved long-term outcomes over the MPA aproach (SF-12 and WOMAC), but had significantly lower flexion at 1 year. The LPA group showed inferior outcomes than the MPA group but had more severe valgus preoperative deformity (p = 0.024). Further studies are required to investigate the potential benefit of quadriceps-sparing approaches.