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Clinical Orthopaedics and Related Research®

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01.06.2010 | Clinical Research

Does Minimally Invasive Surgery Improve Short-term Recovery in Total Knee Arthroplasty?

verfasst von: Tao Cheng, MD, PhD, Tao Liu, MD, PhD, Guoyou Zhang, MD, PhD, Xiaochun Peng, MD, PhD, Xianlong Zhang, MD, PhD

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 6/2010

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Abstract

Background

Concerns have been raised regarding minimally invasive surgery (MIS) and its possible effect on postoperative functional recovery, complications, and survival rate after TKA.

Questions/purposes

We specifically asked whether MIS TKA would be associated with (1) increased operative time, (2) reduced blood loss, (3) shortened hospital stay, (4) faster recovery of ROM, (5) higher knee scores, (6) inferior component positioning, and (7) increased complications.

Methods

We performed a systematic literature search of randomized controlled trials between minimally invasive and standard approaches in TKA that compared operative time, blood loss, ROM, knee scores, component positioning, and complications. We conducted a systematic review and meta-analysis of 13 trials published from 2007 to 2009 of MIS versus standard TKA.

Results

Patients in the MIS group had longer operating times (10–19 minutes). Mean Knee Society scores were better after MIS than after the standard procedure at 6 and 12 weeks postoperatively, but not after 6 months. Improvement in ROM occurred more rapidly in the MIS group 6 days after TKA but later improvements are not clearly documented. We identified no differences between minimally invasive and standard approaches regarding the short-term overall complications and alignment of femoral and tibial components. However, wound healing problems and infections occurred more frequently in the MIS group.

Conclusions

MIS leads to faster recovery than conventional surgery with similar rates of component malalignment but is associated with more frequent delayed wound healing and infections. Potential benefits in long-term survival rate and functional improvement require additional investigation.

Level of Evidence Level II, therapeutic study (systematic review). See the Guidelines for Authors for a complete description of levels of evidence.

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Titel: Does Minimally Invasive Surgery Improve Short-term Recovery in Total Knee Arthroplasty?
verfasst von: Tao Cheng, MD, PhD
Tao Liu, MD, PhD
Guoyou Zhang, MD, PhD
Xiaochun Peng, MD, PhD
Xianlong Zhang, MD, PhD
Publikationsdatum: 01.06.2010
Verlag: Springer-Verlag
Erschienen in: Clinical Orthopaedics and Related Research® / Ausgabe 6/2010
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-010-1285-9

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Abstract

Background

Questions/purposes

Methods

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Conclusions

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