Mini-midvastus versus mini-medial parapatellar approach in simultaneous bilateral total knee arthroplasty with 24-month follow-up.

Abstract

Comparisons of mini-midvastus (mMV) with mini-medial parapatellar (mMPP) approach in total knee arthroplasty (TKA) have been performed in the past but were often compromised by variables such as disease, pain tolerance, bone quality, and surgeon. The aim of this study was to minimize the influence of these factors in order to more accurately evaluate these 2 approaches. Forty-five patients who had bilateral arthritis of the knee with similar deformity and preoperative range of motion (ROM) on both sides agreed to have 1 knee replaced via mMV approach (Group I) and the other via mMPP approach (Group II) were evaluated. Postoperative clinical outcomes, postoperative complications, perioperative parameters, and knee component positioning were analyzed. No significant differences were found between the mMV and mMPP groups with regards to functional assessment, patient satisfaction, postoperative complication, quadricep strength, pain at the point of incision, degree of soft tissue release, as well as ROM. Nor were significant differences found between the 2 groups in terms of perioperative parameters and radiographic component positioning. The present study did not detect any substantive difference between the mMV and mMPP approaches for TKA. The decision between the 2 surgical approaches should be based on surgeon experience and preference.