Aladraii Adnan Ahmed, Allehaibi Lama Zaki, Fattani Amjad Abdulrahman, Alkhudairy Taif Abdullah, Al-Margan Albatoul Mohammed, Al-Dubai Sami Abdo Radman, Mohammed Abdulrahman Abdulraof, Mohorjy Doaa K, Alqarni Abdulhakeem Saeed
Department of Orthopaedics, Research Center, King Abdullah Medical City, Makkah, Saudi Arabia.
College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.
Saudi J Med Med Sci. 2024 Jan-Mar;12(1):35-39. doi: 10.4103/sjmms.sjmms_237_23. Epub 2024 Jan 15.
Subvastus approach and medial parapatellar approach are two major approaches for total knee replacement (TKR). There is no global consensus on the superiority of either approach in terms of functional outcomes.
The present study aimed to evaluate the functional outcome of TKR through subvastus approach and medial parapatellar approach by using patient-reported scores at 3-, 6-, and 12-month post-operative follow-ups.
This prospective cohort follow-up study included patients with knee osteoarthritis who underwent elective primary TKR either through the subvastus or medial parapatellar approaches at King Abdullah Medical City, Makkah city, Kingdom of Saudi Arabia, from January 2019 to December 2022. Scores from the self-reported Oxford Knee Score (OKS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were compared in the two groups of patients at 3-, 6-, and 12-month post-operative follow-ups.
A total of 98 patients were included, of which 37 underwent TKR through the subvastus approach and 61 through the medial parapatellar approach. There was an overall significant change over time in both WOMAC and OKS scores ( < 0.001). Patients who underwent the subvastus approach had significantly higher mean of WOMAC and OKS than patients with the medial parapatellar approach at the 3- and 6-month follow-ups ( < 0.05), but not at the 12-month follow-up.
For TKR, the medial parapatellar approach results in better functional outcomes at the 3- and 6- month follow-up periods compared with the subvastus approach.
股直肌下入路和髌旁内侧入路是全膝关节置换术（TKR）的两种主要入路。在功能结局方面，对于哪种入路更具优势尚无全球共识。
本研究旨在通过股直肌下入路和髌旁内侧入路进行全膝关节置换术，并在术后3个月、6个月和12个月的随访中使用患者报告的评分来评估其功能结局。
这项前瞻性队列随访研究纳入了2019年1月至2022年12月在沙特阿拉伯王国麦加市阿卜杜拉国王医疗城接受择期初次全膝关节置换术的膝骨关节炎患者，这些患者通过股直肌下或髌旁内侧入路进行手术。在术后3个月、6个月和12个月的随访中，比较两组患者自我报告的牛津膝关节评分（OKS）和西安大略和麦克马斯特大学骨关节炎指数（WOMAC）的得分。
共纳入98例患者，其中37例通过股直肌下入路进行全膝关节置换术，61例通过髌旁内侧入路进行手术。WOMAC和OKS评分随时间均有总体显著变化（<0.001）。在3个月和6个月的随访中，接受股直肌下入路的患者WOMAC和OKS的平均得分显著高于接受髌旁内侧入路的患者（<0.05），但在12个月的随访中并非如此。
对于全膝关节置换术，与股直肌下入路相比，髌旁内侧入路在术后3个月和6个月的随访期内功能结局更好。
