Introduction: Total knee arthroplasty has become one of the most successful and safest
surgical procedures in orthopedic surgery. Of the many different types of surgical
exposure, the most common, so-called medial parapatellar (MP) incision is the cut
of the quadriceps tendon, which impairs extensor function. In contrast, subvastus
(S) exposure, which spares the extensor apparatus, may promise better healing. Aim:
The purpose of our prospective observational study at the Orthopedic Clinic of Semmelweis
University is to compare the effects of the MP and the S excision on the early postoperative
period. Method: The 60 patients enrolled were randomly assigned to two different groups
according to the type of intervention. In the study, we measured the effects of the
two different methods of surgical exposure on homogeneous patient groups in the early
postoperative period based on international literature and the parameters we defined.
Results: Visual analog scale (VAS) measured resting and active pain levels for the
first 10 days, suggesting a more pronounced difference in active VAS values for the
S group. In the case of active VAS, patients in the S group also had significantly
less pain on days 2, 3, and 10 than in the MP group. Taking into account the results
of the other days, it is in favour of preserving the integrity of the extensor apparatus
for improved postoperative functionality. Patients' knee joint range of motion was
also measured. On day 1, those in the S group were significantly larger. As the days
progress, MP group members catch up with S group during their rehabilitation. Group
S patients had an average of 1.944 days to extended leg elevation, which is nearly
two days shorter compared to the MP group (p<0.0001). Conclusions: After statistical
analysis of data, subvastus exposure appears to be more beneficial in the rehabilitation
of the early postoperative period. However, large-scale, multicentre observational
studies are required to establish evidence.
