Systematic review of medial parapatellar and subvastus approaches in total knee arthroplasty.

This systematic review was performed to compare the outcomes of the medial parapatellar and subvastus surgical approaches for total knee arthroplasty. Five studies, published between 1993 and 2001 met the inclusion quality standards for the review. The methodological quality of most studies was poor, and they were not sufficiently homogenous for meta-analysis. We found that the evidence was insufficient to demonstrate a clinical or statistically significant difference between the medial parapatellar and subvastus approaches to total knee arthroplasty across all outcomes. Further trials with robust methodology, objective and functional outcome measures, and follow-up beyond 6 to 12 months are required.