Comparison of two minimally invasive implantation instrument-sets for total knee arthroplasty

Martin, Arno; Sheinkop, Mitchell B.; Langhenry, Mary M.; Widemschek, Mark; Benesch, Thomas; Strempel, Archibald von

doi:10.1007/s00167-009-0957-z

Cited by 12 publications

(7 citation statements)

References 41 publications

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“…There was distinct improvement in all patients after TKA, therefore differences between the groups are difficult to determine with our data. The lack of improvement in early clinical outcomes with patientspecific instrumentation is in accordance with other minimally invasive techniques combined with navigation [19,28,41]. Similar to our findings, Pietsch et al [41] conducted a randomized clinical trial of 80 patients divided into conventional instrumentation and patient-specific instrumentation groups and found no difference in the Knee Society score at 3 months.…”

Section: Discussionsupporting

confidence: 89%

Small Improvements in Mechanical Axis Alignment Achieved With MRI versus CT-based Patient-specific Instruments in TKA: A Randomized Clinical Trial

Pfitzner

Abdel

Roth

et al. 2014

Clinical Orthopaedics &Amp; Related Research

101

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Background Patient-specific instrumentation in TKA has the proposed benefits of improving coronal and sagittal alignment and rotation of the components. In contrast, the literature is inconsistent if the use of patient-specific instrumentation improves alignment in comparison to conventional instrumentation. Depending on the manufacturer, patient-specific instrumentation is based on either MRI or CT scans. However, it is unknown whether one patient-specific instrumentation approach is more accurate than the other and if there is a potential benefit in terms of reduction of duration of surgery. Questions/purposes We compared the accuracy of MRIand CT-based patient-specific instrumentation with conventional instrumentation and with each other in TKAs. The three approaches also were compared with respect to validated outcomes scores and duration of surgery. Methods A randomized clinical trial was conducted in which 90 patients were enrolled and divided into three groups: CT-based, MRI-based patient-specific instrumentation, and conventional instrumentation. The groups were not different regarding age, male/female sex distribution, and BMI. In all groups, coronal and sagittal alignments were measured on postoperative standing long-leg and lateral radiographs. Component rotation was measured on CT scans. Clinical outcomes (Knee Society and WOMAC scores) were evaluated preoperatively and at a mean of 3 months postoperatively and the duration of surgery was analyzed for each patient. MRI-and CT-based patientspecific instrumentation groups were first compared with conventional instrumentation, the patient-specific instrumentation groups were compared with each other, and all three approaches were compared for clinical outcome measures and duration of surgery. Results Compared with conventional instrumentation MRI-and CT-based patient-specific instrumentation showed higher accuracy regarding the coronal limb axis

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Section: Discussionsupporting

confidence: 89%

Small Improvements in Mechanical Axis Alignment Achieved With MRI versus CT-based Patient-specific Instruments in TKA: A Randomized Clinical Trial

Pfitzner

Abdel

Roth

et al. 2014

Clinical Orthopaedics &Amp; Related Research

101

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“…Recent studies have shown that the complication rates with MIS for TKA were significantly higher than those with standard TKA. [ 14 26 ] In this study, there were 3 instances of complications in the m-QS group and only 2 in the MMP group, which indicates that the difference between the two groups is not significant. None of the patients experienced any major complications.…”

Section: Discussionmentioning

confidence: 69%

Are There Any Clinical and Radiographic Differences Between Quadriceps-sparing and Mini-medial Parapatellar Approaches in Total Knee Arthroplasty After a Minimum 5 Years of Follow-up?

Huang

Wang

et al. 2015

Chinese Medical Journal

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Background:Although the early clinical outcomes of total knee arthroplasty (TKA) using minimally invasive surgery techniques have been widely described, data on the mid- to long-term outcomes are limited. We designed a retrospective study to compare the two most common TKA techniques – The modified quadriceps-sparing (m-QS) approach and the mini-medial parapatellar (MMP) approach – In terms of the clinical and radiographic parameters, over a minimum follow-up period of 5 years.Methods:The m-QS approach was used in 31 knees and the MMP approach, in 36 knees. Knees in both groups were compared for component position and alignment, knee alignment, length of the skin incision, range of motion, Visual Analog Scale score, muscle torques, Knee Society Score, Western Ontario and McMaster Universities Osteoarthritis Index, and number of complications.Results:There were no major intergroup differences in any of the clinical and radiographic outcomes assessed at the final follow-up examination.Conclusions:On the basis of numbers studied, the m-QS group, which requires more technique, showed equivalent results with the MMP group in the postoperative 5 years. Preservation of the extensor mechanism in the m-QS approach could not ensure any improvement in the clinical outcomes during the mid-term follow-up duration.

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“…The operation is believed to have an intraoperative risk of fracture at the surgical site, damage and rupture of the ligaments or muscles, insufficient removal of cement or bone fragments, skin necrosis due to severe traction, increased chance of infection, improper fixation of implants, and inappropriate implant alignment, all of which have a negative impact on the long-term clinical results, according to some research. 11 12 13 14 15 …”

Section: Discussionmentioning

confidence: 99%

Radiologic Outcomes According to Varus Deformity in Minimally Invasive Surgery Total Knee Arthroplasty

et al. 2016

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PurposeTo identify the accuracy of postoperative implant alignment in minimally invasive surgery total knee arthroplasty (MIS-TKA), based on the degree of varus deformity.Materials and MethodsThe research examined 627 cases of MIS-TKA from November 2005 to December 2007. The cases were categorized according to the preoperative degree of varus deformity in the knee joint in order to compare the postoperative alignment of the implant: less than 5° varus (Group 1, 351 cases), 5° to less than 10° varus (Group 2, 189 cases), 10° to less than 15° varus (Group 3, 59 cases), and 15° varus or more (Group 4, 28 cases).ResultsOn average, the alignment of the tibial implant was 0.2±1.4°, 0.1±1.3°, 0.1±1.6°, and 0.3±1.7° varus, and the tibiofemoral alignment was 5.2±1.9°, 4.7±1.9°, 4.9±1.9°, and 5.1±2.0° valgus for Groups 1, 2, 3, and 4, respectively, in the preoperative stage, indicating no difference between the groups (p>0.05). With respect to the accuracy of the tibial implant alignment, 98.1%, 97.6%, 87.5%, and 86.7% of Groups 1, 2, 3, and 4, respectively, had 0±3° varus angulation, demonstrating a reduced level of accuracy in Groups 3 and 4 (p<0.0001). There was no difference in terms of tibiofemoral alignment, with 83.9%, 82.9%, 85.4%, and 86.7% of each group, respectively, showing 6±3° valgus angulation (p>0.05).ConclusionSatisfactory component alignment was achieved in minimally invasive surgery in total knee arthroplasty, regardless of the degree of varus deformity.

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Comparison of two minimally invasive implantation instrument-sets for total knee arthroplasty

Cited by 12 publications

References 41 publications

Small Improvements in Mechanical Axis Alignment Achieved With MRI versus CT-based Patient-specific Instruments in TKA: A Randomized Clinical Trial

Small Improvements in Mechanical Axis Alignment Achieved With MRI versus CT-based Patient-specific Instruments in TKA: A Randomized Clinical Trial

Are There Any Clinical and Radiographic Differences Between Quadriceps-sparing and Mini-medial Parapatellar Approaches in Total Knee Arthroplasty After a Minimum 5 Years of Follow-up?

Radiologic Outcomes According to Varus Deformity in Minimally Invasive Surgery Total Knee Arthroplasty

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