International Journal of Drug Delivery Technology
Volume 16, Issue 4s

A Comparative Study Of Functional Outcome Of Subvastus Vs Medial Parapatellar Approaches In Total Knee Arthroplasty Procedure

Dr. Akilan Soundararajan Narayanan1*, Dr. Soundararajan Karuppanan2, Dr. Muthukannan Hari Sivanandan3, Dr. Nithin Mathew4, Dr. Vineeth B. Maligi5, Dr. Naveen Baskar S6

1*Post graduate in M.S. Orthopaedics, Vinayaka Mission's Kirupananda Variyar Medical College & Hospital, Salem, University - Vinayaka Mission's Research Foundation (Deemed to be university)
Contact no: 7806974561
2Professor, Department of Orthopaedics, Vinayaka Mission's Kirupananda Variyar Medical College & Hospital, Salem, University - Vinayaka Mission's Research Foundation (Deemed to be university)
3Professor, Department of Orthopaedics, Vinayaka Mission's Kirupananda Variyar Medical College & Hospital, Salem, University - Vinayaka Mission's Research Foundation (Deemed to be university)
4Vinayaka Mission's Kirupananda Variyar Medical College & Hospital, Salem, University - Vinayaka Mission's Research Foundation (Deemed to be university)
5Post graduate in M.S. Orthopaedics, Vinayaka Mission's Kirupananda Variyar Medical College & Hospital, Salem, University - Vinayaka Mission's Research Foundation (Deemed to be university)
6Post graduate in M.S. Orthopaedics, Vinayaka Mission's Kirupananda Variyar Medical College & Hospital, Salem, University - Vinayaka Mission's Research Foundation (Deemed to be university)

ABSTRACT

Background: Total Knee Arthroplasty (TKA) is a widely performed surgical intervention for end-stage knee diseases such as osteoarthritis, rheumatoid arthritis, and avascular necrosis. The surgical approach significantly influences early postoperative recovery and functional outcomes.

AIM: To compare the functional outcome of Subvastus vs Medial Parapatellar approaches in Total Knee Replacement procedure.

Methods: A hospital-based prospective study was conducted on 30 patients with Grade 3 and 4 osteoarthritis (Kellgren–Lawrence classification) undergoing TKA. Participants were randomly assigned to two groups: Group 1 (Subvastus approach, n = 15) and Group 2 (Medial Parapatellar approach, n = 15). Parameters assessed included intraoperative blood loss, surgical duration, pain (VAS), range of motion (ROM), Knee Society Score (KSS), postoperative complications, straight leg raise (SLR), and length of hospital stay (LOS). Follow-ups were conducted on postoperative day 1, at 14 weeks, 6 months, and 1 year.

Results: The Subvastus approach demonstrated significantly reduced intraoperative blood loss (277 ± 44 ml vs 337 ± 54 ml; p = 0.002) and shorter operative time (95 ± 15 min vs 135 ± 13 min; p < 0.001) compared to MPA. Early postoperative outcomes—including pain reduction, faster SLR, and shorter LOS—were significantly better in the Subvastus group. At 14 weeks and 6 months, Subvastus patients showed superior KSS and ROM scores. However, at 1-year follow-up, no statistically significant difference was observed between the two approaches in terms of pain, ROM, or functional scores.

Conclusion: The Subvastus approach in TKA offers superior early postoperative recovery, reduced blood loss, and shorter hospital stay compared to the Medial Parapatellar approach. Nonetheless, long-term functional outcomes between the two approaches remain comparable after one year.

Keywords: Total Knee Arthroplasty (TKA); Subvastus Approach; Medial Parapatellar Approach; Functional Outcome; Knee Society Score (KSS); Range of Motion (ROM); Osteoarthritis; Postoperative Pain; Rehabilitation.

How to cite this article: Narayanan AS, Karuppanan S, Sivanandan MH, Mathew N, Maligi VB, Baskar S N, A Comparative Study Of Functional Outcome Of Subvastus Vs Medial Parapatellar Approaches In Total Knee Arthroplasty Procedure. Int J Drug Deliv Technol. 2026;16(4s): 139-146; DOI: 10.25258/ijddt.16.139-146