Limited use of tourniquet in total knee arthroplasty using the midvastus approach facilitates recovery: a retrospective study

Background: Total knee arthroplasty(TKA) is regarded as one of the most successful orthopedic surgeries. However, there is still a lack of consensus on the use of tourniquets and the choice of surgical approach. This research aimed to compare recovery outcomes in patients undergoing TKA with limited use of tourniquet through the midvastus(MV) approach and the medial parapatellar(MP) approach. Methods: Patients receiving TKA treatment (MV or MP) were retrospectively recruited in this study between June 2019 and June 2024. The demographic, perioperative, and patient satisfaction data were collected and compared between the MV and MP groups. Results: There was no statistical difference in the general data between the two groups of patients, and they were comparable. Compared with MP approach, patients in MV group had shorter incision length, less postoperative drainage volume, smaller hemoglobin difference before and after surgery, shorter postoperative hospital stay, lower VAS score at firstweek after operation, and higher HSS score at first week and firstmonth after operation. In contrast, patients in the MP approach group had a short operative time. Conclusions: The MV approach and the MP approach are both effective options for TKA and can improve the patients’ knee function. The MV approach was beneficial for the patients’ early postoperative recovery, but there was no significant difference in knee function after three months, complications, or satisfaction between the two groups. Clinical trial number : Not applicable.