To evaluate the functional and radiological outcome of total knee replacement for osteoarthritis knee using medial parapatellar approach and posterior stabilized (PS) design.
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Abstract
Background:
Osteoarthritis (OA) of the knee is one of the most common causes of pain and disability among the elderly population worldwide. Total knee arthroplasty (TKA) has emerged as an effective surgical intervention for end-stage osteoarthritis by relieving pain, restoring alignment, and improving functional mobility. The present study was conducted to evaluate the functional and radiological outcomes of total knee replacement using the medial parapatellar approach and posterior stabilized (PS) prosthesis design.
Aim:
To evaluate the functional and radiological outcome of total knee replacement for osteoarthritis knee using medial parapatellar approach and posterior stabilized (PS) design.
Methodology:
This prospective observational analytical study was conducted in the Department of Orthopaedics, R.D. Gardi Medical College and Hospital, Ujjain, Madhya Pradesh, from November 2023 to April 2025 after Institutional Ethics Committee approval. A total of 50 patients aged more than 50 years with Kellgren and Lawrence Grade III and IV osteoarthritis knee were included. All patients underwent cemented total knee arthroplasty through a standard medial parapatellar approach using posterior stabilized implants. Functional assessment was performed using Knee Society Score (KSS) and range of motion (ROM), while radiological assessment was carried out using the Knee Society Total Knee Arthroplasty Radiographic Evaluation and Scoring System. Statistical analysis was performed using IBM SPSS version 22.0.
Results:
The mean age of participants was 63.8 ± 7.9 years, with females constituting 52% of cases. Most patients were overweight (62%) and had Grade IV osteoarthritis (58%). Significant improvement in Knee Society Score was observed from a preoperative mean of 50.06 ± 6.44 to 86.16 ± 5.77 at 1 month, 90.96 ± 4.94 at 3 months, and 92.50 ± 4.16 at 6 months postoperatively. Mean ROM improved from 92.72 ± 13.65° preoperatively to 111.52 ± 5.22° at 6 months. Postoperative complications were minimal, with 94% of patients showing no complications; aseptic loosening, thromboembolism, and superficial infection were observed in 2% each.
Conclusion:
Total knee arthroplasty using the medial parapatellar approach and posterior stabilized design provides excellent functional recovery, significant improvement in range of motion, and a low complication rate in patients with advanced knee osteoarthritis. Proper patient selection, meticulous surgical technique, and structured rehabilitation play a crucial role in achieving favorable postoperative outcomes.
Keywords:
Total knee replacement, osteoarthritis knee, total knee arthroplasty, Knee Society Score, range of motion, posterior stabilized prosthesis, medial parapatellar approach.
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References
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