Comparison of the results of medial parapatellar incision and subvastus incision in total knee prosthesis

Background and Aim: Total knee replacement is one of the most common operations in orthopedic surgery. One of the main goals should be minimizing postoperative complications and increasing patient satisfaction. Our aim is to investigate the relationship between the medial parapatellar incision and the subvastus incision, which are two frequently used incisions in knee prosthesis, with patellofemoral complications, and to compare patient satisfaction. Methods: In this study, we evaluated 488 patients who applied to our hospital between 2010 and 2020, were diagnosed with osteoarthritis, had a total knee prosthesis and were followed up. Of these, 242 had a medial parapatellar (49.6%), and 246 had a total knee prosthesis with a subvastus incision (50.4%). We compared these two patient groups in terms of anterior knee pain, patellar tilt, lateral retinacular release need, insall salvati index and womac score. Results: Among the demographic types of patients with MPP or SV incision and total knee prosthesis, age (p: 0.186), gender (p: 0.769), smoking (p: 0.607), BMI (p: 0.051), accompanying diseases (p: 0.509) ), no significant difference was detected. In the subvastus incision, the need for lateral retinacular release (p: 0.001), insall salvati index (p: 0.001) and patellar tilt (p: 0.001) were found to be significantly less than MPP incision. Anterior knee pain (p: 0.087) and WOMAC scores (0.052) between the two groups were described with a significant meaning. Conclusion: Subvastus incision is advantageous over medial parapatellar incision in terms of patellofemoral complications. However, despite these advantages, no significant difference was found in the womac scores of the patients. Therefore, although subvastus incision decreases patellofemoral complications, it may increase other complications of total knee prosthesis. For this, studies comparing the two incisions in terms of different complications should also be performed. Key words: Total knee arthroplasty, medial parapatellar approach, subvastus approa