Comparing the Sub-Vastus and Medial Parapatellar Approaches in Total Knee Arthroplasty: A Meta-Analysis of Short-Term Outcomes
Bibliographic record
Abstract
Proponents of the Sub-Vastus (SV) approach in primary Total Knee Arthroplasty (TKA) claim superior extensor mechanism function which results in earlier recovery after surgery. We performed a meta-analysis of randomized controlled trials comparing the SV and standard Medial Parapatellar (MPP) approaches in primary TKAs. The study was performed using the Cochrane handbook for systematic reviews guidelines. A total of 28 studies with 2171 patients were included and the mean age of the SV group was 68.2 [standard deviation, ±4.4] and of the MPP group was 68.4 (±3.85). The SV approach resulted in a significant improvement in flexion at day 3 postoperatively [mean difference (MD) = 6°; 95% confidence interval (CI), 0.37-11.71; p < 0.01], but this was not sustainable at 6 weeks, 3 months, and 12 months postoperatively. Similarly, despite a significant reduction in the visual analogue scale score at day 1 postoperatively (MD = -1.19; 95% CI, -1.70 to -0.68; p < 0.01), there was not enough evidence to support its superiority after that. The SV approach led to a reduction in days to straight leg raise (MD = -1.88; 95% CI, -2.45 to -1.31; p < 0.01) and lateral releases [relative risk = 0.49; 95% CI, 0.30-0.82; p < 0.01) with no difference in complication rates ( p = 0.64) but at the expense of a prolonged operation (MD = 13 min; 95% CI, 9.41-16.69; p < 0.01). Our conclusion is that the SV approach provides an alternative to the MPP with some advantages in the first 3 days only after primary TKA surgery.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".