Vertical Incision Orientation Improves Midvastus Arthrotomy in Total Knee Arthroplasty: Superior Pain Relief, Minimal Blood Loss, and Faster Recovery

Author(s):

Serhat Gurbuz*, Hakan Bahar

Background: The midvastus arthrotomy technique is commonly utilized in Total Knee Arthroplasty (TKA) due to its potential to preserve quadriceps integrity and improve early postoperative outcomes. This retrospective cohort study evaluates the impact of incision orientation in the midvastus technique on pain, functional recoveryand surgical outcomes. Materials and methods: A total of 180 patients undergoing TKA were included, divided into three groups: standard midline, horizontally orientedand vertically oriented midvastus incisions. All patients received the same implant and standardized perioperative care. Outcomes such as pain (VAS), function (OKS), blood transfusion ratesand numbness were assessed at 10 days, 1 monthand 3 months. Results: The vertical incision group demonstrated significantly lower VAS scores and faster functional recovery. Blood transfusion rates and numbness incidence were also lowest in this group. Results are supported by p-values and descriptive statistics. Conclusion: Vertical incision orientation in the midvastus approach appears to offer benefits in early postoperative outcomes. However, due to the retrospective nature of this study and the variability in muscle anatomy, further prospective, anatomy-guided studies are necessary to confirm these findings