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01.12.2006 | Study protocol | Ausgabe 1/2006 Open Access

Trials 1/2006

Sub-vastus approach versus the medial parapatellar approach in primary total knee: a randomised controlled trial [ISRCTN44544446]

Trials > Ausgabe 1/2006
Stephen Bridgman, Gayle Walley, Gilbert MacKenzie, Darren Clement, David Griffiths, Nicola Maffulli
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1745-6215-7-23) contains supplementary material, which is available to authorized users.

Competing interests

The author(s) declare that they have no competing interests.

Authors' contributions

SB, DC and DG conceived the trial design. SB, NM and GW have been involved in subsequent adaptations and drafted the manuscript. DG, DC and GM have contributed to adaptations from the original design. All authors read and approved the manuscript.



Thirty thousand knee replacements are performed annually in the UK. There is uncertainty as to the best surgical approach to the knee joint for knee arthroplasty. We planned a randomised controlled trial to compare a standard medial parapatellar arthrotomy with sub-vastus arthrotomy for patients undergoing primary total knee arthroplasty in terms of short and long term knee function.


Patients undergoing primary total knee arthroplasty at the local NHS Trust are to be recruited into the study. Patients are to be randomised into either the subvastus or medial parapatellar approache to knee arthroplasty. The primary outcome measures will be the American Knee Society and WOMAC Scores. The secondary outcome measures will be patient based measures of EuroQol and SF-36. All outcomes will be measured pre-operatively, 1, 6, 12 and 52 weeks post-operatively. We will also review pain intensity using a pain and analgesia diary. Ease of surgical exposure and complications will also be analysed.


Evidence is lacking concerning the best surgical approach to the knee joint for patients undergoing primary total knee replacement. This pragmatic randomised trial tests the hypothesis that the sub-vastus approach is significantly superior to the standard medial parapatellar approach in terms of short and long term knee function.
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