Component Alignment After Minimally Invasive Total Knee Arthroplasty: Results of the First 100 Cases Performed

A prospective randomised study of minimally invasive midvastus total knee arthroplasty compared with standard total knee arthroplasty

“…The volume of the caseload and surgical experience is key to improving outcomes [40] and the literature is sometimes not clear as to the experience of the MIS lead surgeons. Some authors have explained clearly the steps they have taken to learn MIS techniques [13] and indeed others mentioned how many MIS cases they have undertaken prior to commencing the study [41,42], whilst most make no mention of experience. Concerns have therefore been raised about the potential negative bias in the literature of inexperienced surgeons undertaking MIS [42].…”

“…It is increasingly recognised that there is a significant learning curve for certain minimally invasive approaches [8] and that this may be of relevance to the low volume surgeon [23]. The number of cases for the learning curve is also in debate, some have quoted 25 [23], 30 [13] and may be up to 200 cases [47]. A limited exposure may actually produce greater soft tissue trauma secondary to aggressive retraction [8].…”

“…Concerns exist regarding the potential negatives of minimally invasive approaches, particularly with regard to surgical complications (arthrofibrosis, collateral ligament injury, patellar tendon rupture and wound complications) [6], a steep learning curve [7][8][9][10][11][12][13], component mal-position [14][15][16][17] and high revision rates [18]. The type of MIS approach may be influential.…”

Faster recovery after minimally invasive surgery in total knee arthroplasty

“…Minimally invasive TKR requires a learning curve of up to 50 cases for a high volume arthroplasty surgeon [13,17]. In our experience, the minimally invasive medial parapatellar approach may be the easiest approach to convert from the classic approach [16].…”

“…Controversial data are available about minimally invasive surgery (MIS) [2,[5][6][7]17]. Some authors observed early failure with malalignment and early revision.…”