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<article xlink="http://www.w3.org/1999/xlink" dtd-version="1.0" article-type="orthopaedics" lang="en">
  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher">JOHS</journal-id>
      <journal-id journal-id-type="nlm-ta">Journ of Health Scien</journal-id>
      <journal-title-group>
        <journal-title>Journal of HealthCare Sciences</journal-title>
        <abbrev-journal-title abbrev-type="pubmed">Journ of Health Scien</abbrev-journal-title>
      </journal-title-group>
      <issn pub-type="ppub">2231-2196</issn>
      <issn pub-type="opub">0975-5241</issn>
      <publisher>
        <publisher-name>Radiance Research Academy</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="publisher-id">382</article-id>
      <article-id pub-id-type="doi">http://dx.doi.org/10.52533/JOHS.2025.50102</article-id>
      <article-id pub-id-type="doi-url"/>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Orthopaedics</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>The Subvastus Approach for Total Knee Arthroplasty in Obese Patients: A Systematic Review&#13;
</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <name>
            <surname>Daghistani</surname>
            <given-names>Mohammed</given-names>
          </name>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Alharbi</surname>
            <given-names>Samirah</given-names>
          </name>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Almohammadi</surname>
            <given-names>Taghreed</given-names>
          </name>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Sayed</surname>
            <given-names>Anwar</given-names>
          </name>
        </contrib>
      </contrib-group>
      <pub-date pub-type="ppub">
        <day>6</day>
        <month>01</month>
        <year>2025</year>
      </pub-date>
      <volume>5</volume>
      <issue>1</issue>
      <fpage>13</fpage>
      <lpage>23</lpage>
      <permissions>
        <copyright-statement>This article is copyright of Popeye Publishing, 2009</copyright-statement>
        <copyright-year>2009</copyright-year>
        <license license-type="open-access" href="http://creativecommons.org/licenses/by/4.0/">
          <license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) Licence. You may share and adapt the material, but must give appropriate credit to the source, provide a link to the licence, and indicate if changes were made.</license-p>
        </license>
      </permissions>
      <abstract>
        <p>Total Knee Arthroplasty (TKA) represents a pivotal intervention in the management of advanced knee pathologies such as osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis. Various surgical approaches, including the subvastus, medial parapatellar, and midvastus techniques have evolved to optimize outcomes. While the subvastus approach offers potential advantages such as preserving the extensor mechanism and promoting early recovery, its applicability in obese patients remains a subject of debate due to challenges in exposure and patellar eversion. This systematic review explores the efficacy of the subvastus approach in obese patients, addressing both early and late outcomes, and discusses strategies to overcome exposure difficulties. A PRISMA systematic search appraisal was conducted. A systematic literature search of six scientific databases, including PubMed, Web of Science, SCOPUS, EMBASE, MEDLINE and Google Scholar, was conducted until April 20, 2024, to identify all relevant English-articles. Data was extracted from eligible studies. The literature search yielded a total of 983 studies. Eleven papers published from 2000 until 2021 met the inclusion criteria were included in the final analysis. The total number of patients throughout all the included studies was 1147. The main results showed that the subvastus approach for TKA is applicable in obese patients. To overcome its exposure difficulties, a multifaceted approach including preoperative weight management and advanced imaging could aid in optimizing patient selection and planning; furthermore, intraoperatively meticulous soft tissue handling, pneumatic tourniquets, and advancements like navigation systems could enhance exposure and precision; finally, specialized instruments and implants designed for minimally invasive techniques could improve outcomes. Overcoming exposure difficulties in the subvastus approach for TKA in obese patients demands a multifaceted approach blending preoperative planning, intraoperative techniques, and technological innovations. While challenges such as patellar eversion persist, innovative strategies like the mini-subvastus approach demonstrate efficacy in tackling these issues and ensuring successful outcomes in obese patients undergoing TKA.&#13;
</p>
      </abstract>
      <kwd-group>
        <kwd> Arthroplasty</kwd>
        <kwd> Obese patients</kwd>
        <kwd> Replacement</kwd>
        <kwd> Subvastus approach</kwd>
        <kwd> Total knee</kwd>
      </kwd-group>
    </article-meta>
  </front>
</article>