关键词: 膝关节骨关节炎, 股内侧肌下入路, 内侧髌旁入路, 加速康复

Abstract: Objective To compare the early-term clinical outcomes of the primary knee joint arthroplasty via the subvastus approach and the medial parapatellar approach. Methods A total of 69 patients who underwent primary total knee arthroplasty at the Department of Orthopaedics, Anhui Provincial Hospital from March 2015 to September 2016 were enrolled in this study. Among them, 18 patients underwent the subvastus approach and 51 patients underwent the medial parapatellar approach. The operation time, intraoperative blood loss, postoperative drainage volume, postoperative first straight leg raising time, incidence of postoperative deep venous thrombosis of the lower limb, incidence of postoperative lower lime malalignment, swelling of the knee joint （3 days after operation）, range of motion of the knee joint （3 days after operation）, VAS pain scores （3 days after operation）, HSS scores of the knee joint （1 month after operation） were compared between two groups. Results There was no statistical differences in the operation time, intraoperative blood loss, postoperative drainage volume, incidence of postoperative deep venous thrombosis of the lower limb and incidence of postoperative lower lime malalignment （P > 0.05）. However, there was a significant difference in the postoperative first straight leg raising time, swelling of the knee joint （3 days after operation）, range of motion of the knee joint （3 days after operation）, VAS pain scores （3 days after operation）, HSS scores of the knee joint （one month after operation） （P < 0.05）. Conclusion sTotal knee arthroplasty through the subvastus approach has the advantage of less pain, less swelling and better knee function in the early postoperative period compared with through the medial parapatellar approach, moreover, there is no adverse effect on the lower limb alignment after surgery.

Key words: knee osteoarthritis, subvastus approach, medial parapatellar approach, accelerated rehabilitation