Comparison of Postoperative Outcomes Following Medial Parapatellar Versus Medial Subvastus Approaches for Total Knee Arthroplasty in a Single Patient: A Case Report.

Osteoarthritis (OA) is a chronic degenerative condition that impacts the joints, most commonly the knee. The definitive treatment for severe knee OA is surgery with a total knee arthroplasty (TKA), which is traditionally done through a medial parapatellar approach; however, alternative approaches, including the medial subvastus approach, can be utilized. This case compares the postoperative outcomes between the medial parapatellar and medial subvastus TKA approaches. A 68-year-old male with a past surgical history of a right knee TKA presented to the orthopedic clinic with a several-month history of left knee pain, which worsened with walking and prolonged standing. X-ray revealed severe left knee OA, and the patient opted to undergo surgical fixation as prior conservative management had failed. However, prior to surgery, the patient expressed concern as he had a difficult postoperative course following a previous right knee TKA that was done with a medial parapatellar approach. In an attempt to improve early postoperative recovery, the patient underwent a left knee TKA with a medial subvastus approach. The patient had an uncomplicated procedure followed by a remarkable postoperative recovery that consisted of minimal pain, early ambulation, and early use of stairs. This case underscores the value and potential advantages of the medial subvastus approach in TKA, particularly for patients with a history of challenging postoperative recovery following a traditional medial parapatellar approach.