Clinical Experience Using a Minimally Invasive Surgical Approach for Total Knee Arthroplasty

Kolisek, Frank R.; Bonutti, Peter M.; Hozack, William J.; Purtill, James J.; Sharkey, Peter F.; Zelicof, Steven B.; Ragland, Phillip S.; Kester, Mark; Mont, Michael A.; Rothman, Richard H.

doi:10.1016/j.arth.2006.06.004

Cited by 99 publications

(42 citation statements)

References 27 publications

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“…We assume this better result can be attributed to less scar formation resulting from less dissection, including the conservation of all vastus medialis attachments. In contrast, Kolisek and colleagues [12] did not find differences in KSS at 3 and 12 weeks.…”

Section: Resultsmentioning

confidence: 79%

“…All studies which involve minimally subvastus approach have detected correct component orientation without differences compared with standard approach [4,9,12,15,20]. Using a mini-incision midvastus approach, Dalury and Dennis [8] found worse component orientation with the mini-incision technique; however, this study has been criticized by other authors [18].…”

Section: Resultsmentioning

confidence: 79%

“…On the other hand, the hospital stay showed no major differences. Although this fact may be surprising, Boerger and colleagues [4], Zanasi [25], and Kolisek and colleagues [12] also found substantial differences in early knee flexion but not in hospital stay. In contrast, Lombardini and colleagues [15] and Schroer and colleagues [20] found earlier hospital discharge with the minimally invasive subvastus approach.…”

Section: Resultsmentioning

confidence: 99%

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Minimally Invasive Subvastus Approach: Improving the Results of Total Knee Arthroplasty: A Prospective, Randomized Trial

Varela-Egocheaga

Suárez-Suárez

Fernández-Villán

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Minimally invasive knee arthroplasty seeks to diminish the problems of traditional extensile exposures aiming for more rapid rehabilitation of patients after surgery. Questions/purposesTo determine if the subvastus approach results in less perioperative pain and blood loss, shorter hospital stay, and improved function at both early and long-term followup.Methods One hundred patients were enrolled in a prospective, randomized trial. Fifty were operated on using a minimally invasive subvastus approach and the other 50 by a conventional, peripatellar approach. Minimum followup was 3 years. A repeated-measures analysis of variance was used to compare the Knee Society score and range of motion during followup. ResultsThe minimally invasive approach resulted in greater perioperative bleeding but no increase in transfusions. No differences were found in postoperative pain between groups nor did hospital stay show any differences.

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Section: Resultsmentioning

confidence: 79%

Section: Resultsmentioning

confidence: 79%

Section: Resultsmentioning

confidence: 99%

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Minimally Invasive Subvastus Approach: Improving the Results of Total Knee Arthroplasty: A Prospective, Randomized Trial

Varela-Egocheaga

Suárez-Suárez

Fernández-Villán

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…Recently, the development of new instrumentation and techniques has led to the advancement of less invasive TKA. Although the less invasive TKA minimizes postoperative pain, shortens recovery time, and preserves normal tissues, it has been reported that the incidence of delayed wound healing increased because the wound edge was excessively stretched during surgery [6]. These superficial wound problems not only cause additional wound treatment and prolonged hospital stay, but also increase the risk of devastating complications, such as deep infection and full thickness necrosis.…”

Section: Introductionmentioning

confidence: 99%

Transcutaneous oxygen tension in the anterior skin of the knee after minimal incision total knee arthroplasty

et al. 2012

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“…However, other authors raised concerns about increased complications including malalignment and wound problems [24, 25, 28] and some did not identify significant differences with respect to conventional TKR for blood loss, infection or ultimate wound healing [51]. …”

Section: Compare Conventional Surgical Technique Vs Mismentioning

confidence: 99%

Minimally invasive total knee replacement: techniques and results

Picard

Deakin

Balasubramanian

et al. 2018

Eur J Orthop Surg Traumatol

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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.

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Clinical Experience Using a Minimally Invasive Surgical Approach for Total Knee Arthroplasty

Cited by 99 publications

References 27 publications

Minimally Invasive Subvastus Approach: Improving the Results of Total Knee Arthroplasty: A Prospective, Randomized Trial

Minimally Invasive Subvastus Approach: Improving the Results of Total Knee Arthroplasty: A Prospective, Randomized Trial

Transcutaneous oxygen tension in the anterior skin of the knee after minimal incision total knee arthroplasty

Minimally invasive total knee replacement: techniques and results

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