Faster recovery after minimally invasive surgery in total knee arthroplasty

Abstract

Purpose The aim of the study was to identify whether less soft tissue and muscle damage during surgery will allow faster recovery after total knee arthroplasty in comparison with the conventional technique. A limited medial parapatellar approach without tibial medial collateral ligament (MCL) desinsertion was compared with the conventional parapatellar approach. Methods Three hundred patients were randomized either into the minimally invasive group (MIS group) or into the conventional group (CON group). The evaluation was based on the Knee Society Score, range of motion, blood loss, period of hospitalization and postoperative hemoglobin level. Results The MIS group showed faster recovery with immediate postoperative full weight‐bearing and shorter length of stay (5 vs 10 days). Comparable Knee Society Scores (87.5 vs 88), function scores (90) and alignment (5.5° vs 5.2°) between the CON and MIS group were observed at a follow‐up of 24 months. No increase in operative times (52 vs 51 min tourniquet time) or no complications were observed. Reduced blood loss was observed in the MIS group (590 vs 989 ml). Conclusion The MCL sparing limited medial parapatellar approach allows good surgical exposure, easy extension proximally if necessary, contained closure after surgery with less bleeding, faster recovery, full weight‐bearing without aid and most importantly no radiological malalignment. Level of evidence Therapeutic study, Level II.

Effects of tourniquet application on enhanced recovery after surgery (ERAS) and ischemia-reperfusion post-total knee arthroplasty: Full- versus second half-course application

“…Recent emphasis has been placed in TKA on postoperative pain control and soft tissue trauma during surgery. 5,6 We thus recently performed a randomized controlled trial (RCT) to assess pain and swelling caused by ischemic-reperfusion injury after primary TKA, in an attempt to improve recovery and function, while reducing hospital stay. 7 The findings of this study would contribute to improve procedural recommendations for TKA.…”

Effects of Tourniquet Use on Quadriceps Function and Pain in Total Knee Arthroplasty

“…Recent emphasis in total knee arthroplasty (TKA) has focused on post-operative pain control and minimising soft tissue trauma during surgery 1 , 2) , in an attempt to accelerate recovery, return to function, and reduce hospital stay 3) . Traditionally, a thigh tourniquet is used to prevent intra-operative bleeding and improve surgical field visualisation and ease of surgery 4) .…”

Serum C-Reactive Protein Distribution in Minimally Invasive Total Knee Arthroplasty Do Not Differ with Distribution in Conventional Total Knee Arthroplasty

“…Minimally invasive total knee arthroplasty (MITKA) has been developed to reduce trauma of the knee replacement and facilitate rehabilitation after the operation [ 14 ]. A plausible hypothesis is that this reduction in surgical trauma results in lower concentrations of circulating inflammatory biomarkers such as CRP.…”