Minimally invasive surgery total knee arthroplasty is less popular, but the prosthesis designed specifically for MIS provides good survival and PROMs with a minimum follow-up of 10 years

Abstract

Background The concept of minimally invasive surgery (MIS) was introduced in total knee arthroplasty (TKA) in the late 1990s. The number of MIS TKAs has clearly decreased in recent years. An implant designed specifically for MIS TKA has been used all over the world, but there are no reports of long-term postoperative results. The purpose of this study was to characterize long-term clinical results with a minimum follow-up of 10 years. Methods This retrospective study included 109 consecutive patients with 143 NexGen CR-Flex prostheses, which are MIS tibial component prostheses designed specifically for MIS TKA. Twelve-year survival analysis was performed using Kaplan-Meier method. Revision surgery for any reason was the endpoint. Long-term clinical and radiographic results of 74 knees (55%) in 60 patients with more than 10 years of follow-up were analyzed. Results The cumulative survival rate of the single-radius posterior-stabilized TKA of 74 knees was 94.7% (95% confidence interval, 90–99%) at 12 years after surgery. Seven knees (9%) required additional surgery during the 10-year follow-up because of periprosthetic infections. Mean postoperative Knee Society knee score and functional score were 91 and 74 points, respectively. There were no cases of prosthesis breakage, polyethylene wear, or aseptic loosening of the prosthesis. Conclusion The prosthesis designed specifically for MIS TKA is associated with good survival and clinical results with a minimum follow-up of 10 years, even though MIS TKA has become less popular. Level of evidence III

Minimally invasive medial femoral approach to total knee arthroplasty improves short-term outcomes compared to the standard medial parapatellar approach: a systematic review and meta-analysis

“…The results revealed that the relaxation rate of the lateral support band in the MMV group did not differ significantly from that in the MP group. Documents show that [ 7 ] MMV approach requires release of soft tissue and lateral collateral ligaments in order to ensure early postoperation prosthesis stability and soft tissue balance due to small incision. The loosening of the lateral support belt is due to the dislocation of the patella and/or the inclination of the patella found during the operation, which reduces the tendency of the dislocation of the external patella by loosening the lateral support of the, improves the cheekbone force line and the trajectory of the patella, but can also lead to complications such as damage to the blood supply of the patella, necrosis of the patella, and poor healing of the soft tissue [ 38 ].…”

“…The advancement of science and technology has led to the widespread adoption of minimally invasive surgery (MIS) in clinical practice, as it offers the potential to enhance short-term recovery and minimize complications. Research has demonstrated that MIS surgery can result in reduced postoperative pain [ 4 – 6 ], faster restoration of quadriceps function [ 4 , 5 , 7 ], improved early-stage knee mobility [ 4 – 8 ], and greater cost-effectiveness compared to standard total knee arthroplasty [ 9 ].…”

Safety and Efficacy of Single Condylar Knee Prosthesis When Treating Knee Single Compartment Osteoarthritis: A Prospective, Case-Randomized Controlled Study

“…Swienckowski et al reported 41 patients (46 knees) with single condylar replacement of knee joint, whose 11-year survival rate was 92% [ 36 ]. Hopper GP et al have indicated that patients undergoing unicondylar knee prosthesis replacement have a higher quality of life than patients with total knee prosthesis replacement, specifically in 96.7% of patients who can participate in sports activities, while only 63.3% of patients with total knee prosthesis replacement [ 37 ]. In 1988, Mac Kinnon et al reported that the 57-month survival rate of knee unicondylar replacement was about 95% [ 38 ].…”

Role of Dithiothreitol in Detection of Orthopaedic Implant-Associated Infections

“…Minimally invasive procedures as well as robotic surgery have bloomed during the last decades, and implant related surgeries are now performed with increased precision and fewer complications. Bioengineering technology has evolved to provide dedicated implants for minimally invasive approaches with good long-term outcomes [1]. Additionally, customised implants, specifically designed for each patient, are a promising tool, although their implementation has not been established yet due to studies showing contradictory results [2].…”