Comparison of the midvastus muscle-splitting approach with the median parapatellar approach in total knee arthroplasty

A total of 100 patients having bilateral total knee replacements simultaneously were randomized prospectively-one knee having a vastus muscle-splitting approach and the other knee having a median parapatellar approach-to evaluate differences in lateral release, postoperative rehabilitation, ease of approach, and complications in total knee replacement surgery. There were 25 lateral releases on the muscle-splitting side and 26 on the median parapatellar side (P =.871). There were no differences in range of motion on day 2 or discharge, straight-leg raise, terminal knee extension, extensor lag, lateral release, or rehabilitation. There were 2 postoperative hematomas and 1 manipulation, all on the muscle-splitting side. All complications occurred from the muscle-splitting side. The muscle-splitting approach cannot be recommended as being superior to the median parapatellar approach.