Montree Siripaiboonkij¹, Jarawee Lodthong¹, Nattakarn Jirakranon¹

Background: Variables such as implant prosthesis type, preservation of posterior cruciate ligament retaining (CR), standard medial parapatellar (MP), or minimally invasive surgical approach have been influenced by the outcomes of total knee arthroplasty (TKA). Previous studies that did not control similar factors, so the results have been controversial.

Objective: To compare early outcomes of standard MP and subvastus (SV) approach in mobile bearing with CR (MBCR) in TKA.

Materials and Methods: Sixty-six TKA by MB implant and CR technique were enrolled between February 2022 and December 2023 at BMA General Hospital and randomized equally between the control (MP) group and SV groups with early postoperative up to eight weeks follow-up.

Results: Of the 43 patients, 20 patients underwent unilateral TKAs and 23 patients had bilateral TKAs. The mean age of the patients was 70.2±6.7 years. The majority of them were women at 83.7%. The median preoperative varus deformity was 4.0 (IQR 2.5 to 6.5) degrees. The SV group had significantly better outcomes in operative time (p=0.002), tourniquet time (p=0.007), less blood loss (p=0.038), and get more straight leg raising at 6-hour, 12-hour, and 24-hour (p=0.009, 0.003, and 0.001, respectively). There was no difference between the two groups in incision length, knee society score (KSS), pain score, and duration of stay.

Conclusion: TKA under MBCR using SV approach has an early advantage outcome over standard MP approach. The authors gave confidence for these prosthesis type, design, and approach.

Received 15 July 2024 | Revised 30 January 2025 | Accepted 6 February 2025

DOI: 10.35755/jmedassocthai.2025.4.257-264-01316