The vastus medialis muscle-splitting approach: a technique for total knee arthroplasty

Twenty-five patients who had 26 primary total knee replacements using a standard medial parapatellar arthrotomy (MPP) were prospectively compared with 14 patients who had 15 primary total knee replacements using an alternative vastus medialis muscle-splitting (VMS) arthrotomy. The randomized groups were compared with regards to daily range of motion, ability to straight-leg raise, and Knee Society scores pre-op, 1 week, and 6 weeks post-operatively. The mean day to discharge included a stay on the Physical Therapy and Rehabilitation Unit for all patients. The return of quadriceps strength, as manifested by the ability to straight-leg raise, was significantly (P<0.05) earlier in the VMS approach (4.0 days) vs. the MPP approach (7.1 days). We could not find a difference in the Knee Society scores between the two approaches (groups). The mean day to discharge was 13.8 days in the VMS approach vs. 19.4 days in the MPP approach.