Comparison of Subvastus and Medial Parapatellar Approaches in Total Knee Arthroplasty for Patients Aged Over 75 Years: Implications for Postoperative Rehabilitation and Early Mobilization
Medical Science Monitor, cilt.32, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 32
- Basım Tarihi: 2026
- Doi Numarası: 10.12659/msm.952375
- Dergi Adı: Medical Science Monitor
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
- Anahtar Kelimeler: Aged, 80 and Over, Orthopedics, Rehabilitation, Retrospective Studies, Orthopedics, Rehabilitation, Retrospective Studies, Arthroplasty, Replacement, Knee
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Total knee arthroplasty (TKA) is increasingly performed in older patients to manage severe osteoarthritis. Given the aging population, optimizing surgical techniques for this age group has become increasingly important. The surgical approach impacts postoperative outcomes, particularly in patients aged 75 years and over, who are prone to immobilization-related complications. This study compared the subvastus (SV) and medial parapatel-lar (MP) approaches, focusing on rehabilitation, early mobilization, and complications. Material/Methods: A retrospective trial included 60 patients aged over 75 years with stage IV osteoarthritis, undergoing TKA. Patients were divided into SV or MP approaches. Outcomes included time to straight leg raise (SLR), range of motion (ROM), pain (visual analog scale, VAS), length of hospital stay, and complications. Results: The SV group achieved earlier SLR (1.7 vs 3.4 days, P=0.001), better ROM at 1 week (94° vs 79°, P=0.008), lower VAS scores at day 3 (4.0 vs 6.0, P=0.02), and shorter hospital stay (5.0 vs 6.7 days, P=0.03). Blood loss was slightly higher in the SV group (360.5 vs 340.2 mL, P=0.76). Immobilization-related complications were lower in the SV group (3.3% vs 10%, P=0.24). Conclusions: The SV approach enhanced early mobilization and rehabilitation in older patients, potentially reducing immo-bilization-related complications, despite slightly higher blood loss. These findings suggest that the subvastus approach may be preferable in geriatric patients to enhance recovery outcomes.