Complications After Minimally Invasive Total Knee Arthroplasty as Compared With Traditional Incision Techniques

Gandhi, Rajiv; Smith, H. W.; Lefaivre, Kelly A.; Davey, J. Rod; Mahomed, Nizar N.

doi:10.1016/j.arth.2009.11.022

Cited by 41 publications

(44 citation statements)

References 35 publications

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“…However, even with appropriate instrumentations, deep anatomic structures of the knee are very difficult to visualize such as the popliteus tendon and particularly it’s femoral insertion, but also the posterior horn of the lateral meniscus, the lateral synovium tissue and even more difficult to see are the ligament collateral ligament (LCL) and the biceps tendon [27]. Despite the small MIS field of view, surgeons may still see reasonably well in slim and easy knee, but it becomes more challenging with overweight patients, with stiff knee and/or patella baja [70].…”

Section: Potential Limitations Of Mismentioning

confidence: 99%

“…In 2011, a meta-analysis compared complications between MIS and conventional knee replacement and they clearly found increasing number of complications with MIS compared to conventional TKR [27]. Indeed, MIS surgery seemed to demonstrate greater prevalence of skin necrosis and delayed wound healing with more superficial wound and even more deep infections, three times more than conventional TKR.…”

Section: Potential Limitations Of Mismentioning

confidence: 99%

“…Even worse complications, such as peroneal nerve damage [27], patella tendon rupture [28] or acute compartment syndrome [29], were attributed to the lack of vision of the lateral compartment in particular.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Potential Limitations Of Mismentioning

confidence: 99%

Section: Potential Limitations Of Mismentioning

confidence: 99%

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Minimally invasive total knee replacement: techniques and results

Picard

Deakin

Balasubramanian

et al. 2018

Eur J Orthop Surg Traumatol

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“…In Hinblick auf die minimalinvasive Knieendoprothetik zeigen jüngere Arbeiten einen Nachteil durch eine erhöhte Komplikationsrate[54,55]. Um diesen Aspekt angemessen zu untersuchen, haben Gandhi und Mitarbeiter die Komplikationshäufigkeit zum Endpunkt ihrer Metaanalyse gemacht und ebenfalls eine erhöhte Komplikationsrate bei Anwendung der minimalinvasiven Technik gefunden[58].In Zusammenschau der Metaanalysen ergibt sich ein positiver Effekt in der frühen postoperativen Rehabilitationsphase. Die eingangs gestellte Frage kann also eindeutig positiv beantwortet werden: Patienten, bei denen eine Knieprothese in minimalinvasiver Technik implantiert worden ist, haben eine kürzere Rehabilitation verglichen mit Patienten, bei denen ein Standardzugang angewendet wurde.…”

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Minimalinvasive Zugänge am Kniegelenk - evidenzbasierter Vorteil in der Knieendoprothetik?

2013

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The impact of minimally invasive surgical techniques for implantation of a total knee arthroplasty is evaluated according to evidence-based medicine criteria. The patient-relevant clinical question can be formulated as: Is the rehabilitation of osteoarthritis patients with minimally invasive implantation of total knee arthroplasty faster compared to those with the conventional approach. The available literature is sorted and critically appraised with regard to methodological quality and risk of bias. Following the results of the meta-analyses the clinical question can be positively answered. Following the aspect of a structured evolution for surgical techniques, the meaning of a minimally invasive technique for total knee arthroplasty cannot be answered finally. Under the impression of more frequent surgical complications, the rating of the procedure is conservative. A general advantage is not apparent. Further studies investigating surgical learning curves, proper patient selection and the selection of the patient for such techniques are required, before the final judgement on the use of this technique can be formed.

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“…[1][2][3] After an initial great enthusiasm, diff erent publications showed poor results while a large number of complications persuaded many surgeons to desist and to return to more classical approaches. Despite this, the innovation encouraged surgeons and researchers to better understand the reasons for failure and for the unsatisfactory results claimed by some patients.…”

mentioning

confidence: 99%

The future of knee arthroplasty

Benazzo

2012

Bone & Joint 360

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Complications After Minimally Invasive Total Knee Arthroplasty as Compared With Traditional Incision Techniques

Cited by 41 publications

References 35 publications

Minimally invasive total knee replacement: techniques and results

Minimally invasive total knee replacement: techniques and results

Minimalinvasive Zugänge am Kniegelenk - evidenzbasierter Vorteil in der Knieendoprothetik?

The future of knee arthroplasty

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