Minimally invasive total knee replacement: principles and technique.

Department of Orthopedics, University of Utah, 2380 N 400 E, Suite G, North Logan, UT 84341, USA.
Orthopedic Clinics of North America (Impact Factor: 1.7). 05/2004; 35(2):235-45. DOI: 10.1016/S0030-5898(03)00113-5
Source: PubMed

ABSTRACT Recent attention toward minimally invasive approaches to joint replacement has resulted in new MIS TKA techniques for the implant of conventional TKA implant components. These proposed techniques must be evaluated thoroughly and changes approached with caution. Medial and lateral techniques that minimize interruption and dissection of neuro-vascular tissues, muscles, tendons, and ligament shave been described. Patients who have undergone these procedures have benefited short term from quicker recovery time and less pain and have benefited long term from the use of conventional prosthesis. Before MIS can become an accepted surgical technique for TKA, a clear understanding of the unique guiding principles behind MIS TKA must be understood and realized. Once these basic principles are followed and the surgeon is familiar with MIS TKA techniques, this technique should prove to be a substantial step forward in the continuum of TKA procedure development.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Zusammenfassung Bislang beschriebene Operationstechniken zum minimal-invasiven Kniegelenkersatz benutzen einen verkürzten parapatellaren, einen „Quad-sparing-“ oder einen Midvastuszugang, wobei das Femur zuerst reseziert wird und die Resektionen knochenreferenziert sind. Deshalb wurde eine Operationstechnik entwickelt, bei welcher der Streckapparat vollständig geschont wird, indem ein subkutaner Subvastuszugang benutzt wird. Die Tibia wird zuerst reseziert und die folgenden Resektionen sind weichteilreferenziert. Die kurzfristigen Ergebnisse dieser und anderer minimal-invasiver Operationstechniken zeigen eine schnellere Rehabilitation bei einem geringeren postoperativen Schmerz, jedoch ebenso eine verlängerte Operationszeit mit erhöhtem Implantationsfehlerrisiko. Deshalb sollten minimal-invasive Operationstechniken zum Kniegelenkersatz allenfalls schrittweise eingeführt werden. Langzeitresultate bleiben ohnehin abzuwarten.
    Der Orthopäde 12/2007; 36(12):1129-1134. · 0.67 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: L’applicazione della chirurgia mini-invasiva (MIS) alla protesi totale di ginocchio costituisce una tendenza non eludibile nel momento in cui la opportunità di conservare quanto più possibile le strutture anatomiche, ampiamente accettata concettualmente, si stia affermando anche nel riscontro clinico.
  • [Show abstract] [Hide abstract]
    ABSTRACT: There has been recent attention concerning minimally invasive techniques for knee arthroplasty. It is not clear whether these complicated techniques can be reproduced across multiple centers and for all surgeons. This prospective, randomized, multicenter study was carried out to assess safety and efficacy of a minimally invasive total knee arthroplasty. The study consisted of 80 knees. There were no differences in blood loss, operative time for completion of surgery, infection, and ultimate wound healing. There were 4 knees with delayed wound healing in the minimally invasive surgical technique group versus 1 in the standard group, which did not affect outcome. Early clinical and radiographic results were also indistinguishable. At 12 weeks follow-up, there was no difference in mean Knee Society objective and functional scores. In summary, in this study, minimal incision total knee arthroplasty demonstrated no improvement over a standard approach.
    The Journal of Arthroplasty 01/2007; 22(1):8–13. · 2.37 Impact Factor