Minimally invasive versus conventional approaches in total knee replacement/arthroplasty: A review of the literature

Tzatzairis, Themistoklis; Fiska, Aliki; Ververidis, Athanasios; Tilkeridis, Konstantinos; Kazakos, Konstantinos; Drosos, Georgios I.

doi:10.1016/j.jor.2018.03.026

Cited by 18 publications

(13 citation statements)

References 79 publications

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“…This approach closes with restoration of the anatomy that results in a robust double-layered watertight seal closure of the proximal half of the arthrotomy, which enables or tolerates an aggressive postoperative patient behavior, knee ROM or function [ 7 ]. Although the advantages of a specific surgical approach in the knee arthroplasty have been a controversial topic, several studies have shown that with quadriceps-sparing approaches that patients may possibly have a quicker rehabilitation in the short term, which may therefore enhance outpatient knee arthroplasty [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

First Reported Series of Outpatient Total Knee Arthroplasty in the Middle East

et al. 2020

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Background: Outpatient total knee arthroplasty (TKA) is becoming more commonplace in the United States. Alternatively, the current practice in the Middle East involves an inpatient stay of 7-10 days in the hospital after TKA. This study reports the early results of the first reported series of outpatient TKA performed on patients in the Middle East and compares the clinical and functional outcomes with those of patients who underwent inpatient TKA. Methods: Eighty-eight patients underwent TKA (inpatient: 44 and outpatient: 44) using the modified intervastus approach in 2 hospitals in the Middle East from 2017 to 2019. Clinical and functional outcomes were assessed by recording the Knee Injury and Osteoarthritis Outcome Score, visual analog scale (VAS) for pain, and knee range of motion (ROM) preoperatively, on the day of surgery, and postoperatively at 2 weeks, 6 weeks, 3 months, and 6 months. Results: Two patients undergoing outpatient TKA had complications: one patient suffered a periprosthetic fracture on postoperative day 10 after a fall, and the other patient had drainage on postoperative day 5. No complications occurred in the inpatient TKA cohort. There were no significant differences observed in the VAS scores or knee ROM numbers recorded for inpatient and outpatient TKA groups at any of the follow-up periods. Overall, the Knee Injury and Osteoarthritis Outcome Score, VAS, and ROM significantly improved 6 months after surgery compared with preoperative values for both inpatient and outpatient TKA groups. Conclusions: Outpatient TKA was safely implemented when compared with inpatient TKA, with satisfactory results. A total of 2 complications were seen in this study, which we believe are unrelated to the patient's discharge status. The concept of outpatient TKA using the modified intervastus approach was very well accepted by the patients in this study and can potentially be applied safely elsewhere in the region.

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Section: Discussionmentioning

confidence: 99%

First Reported Series of Outpatient Total Knee Arthroplasty in the Middle East

et al. 2020

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“…Faced with an aging population, the prevalence of OA is increasing, and joint replacement surgery is becoming more common. 86,87 Postsurgical complications include instability, infection, fracture, and loosening, and the ability to discriminate between infection and aseptic loosening has important implications for patient management. [88][89][90][91] The first-line modality after hip or knee arthroplasty is radiography, which can show subsequent fractures and dislocations.…”

Section: Orthopedic Complicationsmentioning

confidence: 99%

Novel Musculoskeletal and Orthopedic Applications of 18F-Sodium Fluoride PET

et al. 2021

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The bone-seeking properties of 18 F-sodium fluoride (NaF) were first described in 1962 by Blau and colleagues, 1 who used this positron-emitting radiotracer in skeletal scintigraphy. Both high uptake by bone and rapid plasma clearance of NaF were determined to be advantages in imaging skeletal metabolism. 2 The mechanism of NaF uptake relies on the exchange of OH À for 18 F À , converting hydroxyapatite on the surface of the bone matrix to fluorapatite. 2,3 One hour after NaF is administered intravenously, only 10% remains in the plasma compartment because of a first-pass Conflict of interest: The authors have declared no conflicts of interest.

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“…Possible problems with the surgical technique include its steep surgical learning curve, longer operative time, compromised surgical exposure, technical errors (e.g. fracture or component malposition), and neurovascular damage [5][6][7][8][9][10][11]. Several authors expressed concerns that MIS approaches may lead to component misalignment [12] and perioperative complications such as local wound-related problems, deep venous thrombosis (DVT) and pulmonary embolism (PE) [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Comparison of minimally invasive approaches and standard median parapatellar approach for total knee arthroplasty: A systematic review and network meta-analysis of randomized controlled trials

Zhang

Rüwald

et al. 2021

THC

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BACKGROUND: Minimally invasive total knee arthroplasty (TKA) has been actively advertised by the orthopedic industry. The purpose of this network meta-analysis was to comprehensively compare the effectiveness of four minimally invasive surgery (MIS) approaches and the medial parapatellar (MPP) approach to improve the American Knee Society Score (KSS) in primary TKA. MATERIALS AND METHODS: Studies were comprehensively searched on PubMed, Embase, Cochrane Library (CENTRAL), Web of Science and Science Direct up to June 2018 with a major focus on the outcome of KSS. Risk of bias was assessed using the Cochrane risk of bias tool. Quality assessment was performed using the GRADE system. Both pair-wise and network meta-analyses are calculated to comprehensively compare the effectiveness of four MIS and TKA approaches. RESULTS: Eleven trials with 1025 knees undergoing TKA were included. Our analysis showed that both MPP and MIS approaches provided improvement in terms of short-term (four-eight weeks) total, objective and functional KSS score. The network-meta analysis revealed that MIS approaches showed a trend towards superior KSS improvement over standard MPP approaches. However, statistical advantages were only observed in the mini-MPP group for functional KSS scores when compared with conventional MPP and quadriceps-sparing (QS) group. CONCLUSIONS: Evidence shows that MIS TKA approaches are effective alternatives to MPP approaches. However, orthopedic surgeons should be cautiously optimistic about minimally invasive TKA in terms of KSS improvement.

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Minimally invasive versus conventional approaches in total knee replacement/arthroplasty: A review of the literature

Abstract: MIS approaches seem to provide advantages in the immediate post-operative period accompanied by increased reports of complications. Consequently, further investigation based on large well-designed studies with long-term results are warranted to further clarify MIS effectiveness/safety.

Cited by 18 publications

References 79 publications

First Reported Series of Outpatient Total Knee Arthroplasty in the Middle East

First Reported Series of Outpatient Total Knee Arthroplasty in the Middle East

Novel Musculoskeletal and Orthopedic Applications of 18F-Sodium Fluoride PET

Comparison of minimally invasive approaches and standard median parapatellar approach for total knee arthroplasty: A systematic review and network meta-analysis of randomized controlled trials

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