A meta-analysis of minimally invasive and conventional medial parapatella approaches for primary total knee arthroplasty

Li, Canfeng; Zeng, Yi; Shen, Bin; Kang, Pengde; Yang, Jing; Zhou, Zongke; Pei, Fuxing

doi:10.1007/s00167-014-2837-4

Cited by 22 publications

(22 citation statements)

References 62 publications

(106 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…First, the arthrotomy extended into the quadriceps tendon less than 4 cm above the upper pole of the patella in the MMP and QS groups but extended 6-8 cm in the MP group; second, the patella was everted from the beginning of the femoral resection to the end when patella resurfacing was performed in the MP group, whereas in the MMP and QS groups, the patella was not everted during the surgery. Many comparative studies of the MMP, QS and MP approaches have reported good clinical results but inferior lower limb mechanical axis and malposition at the shortterm follow-up for MMP [32,33] and QS [8,[34][35][36] because of the limited working space compared with the MP approach. In addition, some studies indicated that the MP approach may affect patellar tracking, AKP and the patellar position [8,[34][35][36].…”

Section: Discussionmentioning

confidence: 99%

Comparisons among three approaches—two minimally invasive and one conventional—for total knee arthroplasty: a retrospective cohort study with minimum follow-up of 10 years

Yuan

Sun

Fan

et al. 2019

Preprint

View full text Add to dashboard Cite

BackgroundFew studies have investigated whether the mini-medial parapatellar (MMP) and quadriceps-sparing (QS) approaches have good long-term results compared to the conventional medial parapatellar (MP) approach in terms of clinical evaluations and radiographic assessments for total knee arthroplasty (TKA). The purpose of this study was to perform comparisons among the MMP, QS and MP approaches with a follow-up at 10 to 17 years.MethodsThis is a retrospective comparative study of 93 patients who underwent MMP TKA (32 TKAs), QS TKA (47 TKAs) or MP TKA (31 TKAs) with the same arthroplasty system. The clinical evaluations were performed according to the new American Knee Society score (KSS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the visual analogue scale (VAS), range of motion (ROM), incidence of anterior knee pain (AKP), the Feller patellofemoral score (PFS), the reoperation rate and the complication rates. Radiographic assessments included observation of the mechanical axis of the lower limb and calculations of the lateral distal femoral angle (LDFA), femoral flexion angle (FFA), medial proximal tibial angle (MPTA), tibial slope angle (TSA), lateral patella displacement (LPD), and lateral patella tilt (LPT).ResultsThere were no differences in the long-term follow-up results of the new KSS, WOMAC score, ROM, VAS, patellofemoral functions, reoperation rate or complication rates among the groups. In addition, no radiographic differences in terms of lower limb mechanical axis or femoral, tibial or patellar position were observed.ConclusionThese results provide conclusive evidence that equivalent, long-term clinical results can be obtained using any one of these three approaches.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparisons among three approaches—two minimally invasive and one conventional—for total knee arthroplasty: a retrospective cohort study with minimum follow-up of 10 years

Yuan

Sun

Fan

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…However, results are still not conclusive. In general, MIS approaches appear to give better earlier flexion and/or range of motion [52–58] although not for all MIS approaches [52, 53]. The majority showed earlier straight leg raise [52, 53, 55] but not all [54].…”

Section: Compare Conventional Surgical Technique Vs Mismentioning

confidence: 99%

“…In general, MIS approaches appear to give better earlier flexion and/or range of motion [52–58] although not for all MIS approaches [52, 53]. The majority showed earlier straight leg raise [52, 53, 55] but not all [54]. MIS appears to improve immediate post-operative pain scores [52, 54] and early KSS [52, 53, 57] although one analysis found no difference in KSS [54].…”

Section: Compare Conventional Surgical Technique Vs Mismentioning

confidence: 99%

“…The majority showed earlier straight leg raise [52, 53, 55] but not all [54]. MIS appears to improve immediate post-operative pain scores [52, 54] and early KSS [52, 53, 57] although one analysis found no difference in KSS [54]. Based on the current meta-analyses [52–58] there are conflicting results for blood loss, LoS, wound problems and peri-operative complications between MIS and standard approaches, so it is still not easy to draw conclusions.…”

Section: Compare Conventional Surgical Technique Vs Mismentioning

confidence: 99%

See 1 more Smart Citation

Minimally invasive total knee replacement: techniques and results

Picard

Deakin

Balasubramanian

et al. 2018

Eur J Orthop Surg Traumatol

View full text Add to dashboard Cite

In this review, we outlined the definition of minimally invasive surgery (MIS) in total knee replacement (TKR) and described the different surgical approaches reported in the literature. Afterwards, we went through the most recent studies assessing MIS TKR. Next, we searched for potential limitations of MIS knee replacement and tried to answer the following questions: Are there selective criteria and specific patient selection for MIS knee surgery? If there are, then what are they? After all, a discussion and conclusion completed this article. There is certainly room for MIS or at least less invasive surgery for appropriate selected patients. Nonetheless, there are differences between approaches. Mini-medial parapatellar is easy to master, quick to perform and potentially extendable, whereas mini-subvastus and mini-midvastus are trickier and require more caution related to risk of haematoma and vastus medialis oblique (VMO) nerve damage. Current evidence on the safety and efficacy of mini-incision surgery for TKR does not appear fully adequate for the procedure to be used without special arrangements for consent and for audit or continuing research. There is an argument that a sudden jump from standard TKR to MIS TKR, especially without computer assistance such as navigation, patient-specific instrumentation or robotic, may breach a surgeon’s duty of care towards patients because it exposes patients to unnecessary risks. As a final point, more evidence is required on the long-term safety and efficacy of this procedure which will give objective shed light on real benefits of MIS TKR.

show abstract

“…Las técnicas con incisiones mínimamente invasivas se van imponiendo por sus ventajas, al ser capaces de proporcionar una rehabilitación y recuperación funcional precoces. Las posibles complicaciones debidas al abordaje mínimo no parecen ser importantes y disminuyen a medida que aumenta la experiencia del cirujano y con el desarrollo de nuevos instrumentales quirúrgicos (50).…”

Section: Analgesia Multimodalunclassified

Abordaje del dolor agudo en traumatología

Álvaro¹

2017

Rev. Soc. Esp. Dolor.

View full text Add to dashboard Cite

Instrucciones de citación para el artículo / Citation instructions for the article:Oteo Álvaro Ángel. Abordaje del dolor agudo en traumatología / Acute pain management in orthopedics. Rev. Soc. Esp. Dolor. 2017. doi: 10.20986/resed.2017.3639/2017 Este es un archivo PDF de un manuscrito inédito que ha sido aceptado para su publicación en la Revista de la Sociedad Española del Dolor. Como un servicio a nuestros clientes estamos proporcionando esta primera versión del manuscrito en estado de prepublicación. El manuscrito será sometido a la corrección de estilo final, composición y revisión de la prueba resultante antes de que se publique en su forma final. Tenga en cuenta que durante el proceso de producción se pueden dar errores lo que podría afectar el contenido final. El copyright y todos los derechos legales que se aplican al artículo pertenecen a la Revista de la Sociedad Española de Dolor.

show abstract

A meta-analysis of minimally invasive and conventional medial parapatella approaches for primary total knee arthroplasty

Abstract: Therapeutic study, Level II.

Cited by 22 publications

References 62 publications

Comparisons among three approaches—two minimally invasive and one conventional—for total knee arthroplasty: a retrospective cohort study with minimum follow-up of 10 years

Comparisons among three approaches—two minimally invasive and one conventional—for total knee arthroplasty: a retrospective cohort study with minimum follow-up of 10 years

Minimally invasive total knee replacement: techniques and results

Abordaje del dolor agudo en traumatología

Contact Info

Product

Resources

About