The MSV approach ranked better concerning clinical scores ( the lowest visual analogic scale , the higher KSS and KSFS ) and functional outcomes ( the shortest straight leg raise , the greatest degree of flexion and range of motion ) .
Concerning perioperative data , the MSV evidence d the shortest hospital stay , while the MPP the shortest surgical duration and lowest estimated blood loss .
According to the main findings of the present study , the mini-subvastus approach for total knee arthroplasty demonstrated superior overall compared to the other approaches .
Alternatives to the classical medial parapatellar ( MPP ) approach for total knee arthroplasty ( TKA ) include the mini-medial parapatellar ( MMPP ) , mini-subvastus ( MSV ) , mini-midvastus ( MMV ) and quadriceps-sparing ( QS ) approaches .
The best approach has been not fully clarified .
The purpose of the present study was to conduct a Bayesian network meta- analysis comparing these approaches .
Is Obesity a Contraindication for Minimal Invasive Total Knee Replacement? A Prospective Randomized Control Trial
Background Although total knee replacement ( TKR ) has been proven a very successful treatment modality for the end-stage knee osteoarthritis ( OA ) in obese patients , the rehabilitation period often is long and painful . Minimal invasive surgery ( MIS ) has gained much attention in TKR promising fast and less painful recovery . However , little is known about the effectiveness of the technique in the obese adult population . Methods One hundred consecutive patients with body mass index ( BMI ) > 30 kg/m2 and tricompartmental knee OA were r and omly assigned to undergo either st and ard TKR ( 50 patients ) or MIS-TKR ( 50 patients ) . The patients were assessed clinical ly and radiologically before the procedure and at subsequent postoperative follow-up visits , until 2 years after the operation . Results Knee society function and pain scores were significantly higher in MIS group for 3 months following surgery . Patients after MIS had also lower levels of pain during hospitalization . Tourniquet time was on average 7 min longer during MIS-TKR ( p = 0.03 ) but operative time was almost equal in both groups ( p = 0.11 ) . No statistical significant difference was found between groups regarding the amount of blood loss ( p = 0.49 ) or incidence of allogeneic blood transfusion ( p = 0.27 ) . Active straight leg raising was achieved 2.2 days earlier , on average , after MIS-TKR ( p < 0.001 ) . No severe complications or residual coronal and sagittal imbalance were identified . Component alignment was in normal limits and similar in both groups . In MIS group , higher BMI did not have a negative predictive effect on knee pain and function . Conclusions MIS is a reliable and safe option in obese patients undergoing TKR regardless the level of BMI . It is associated with improved early clinical outcome without sacrificing radiographic positioning of the implants
The MSV approach ranked better concerning clinical scores ( the lowest visual analogic scale , the higher KSS and KSFS ) and functional outcomes ( the shortest straight leg raise , the greatest degree of flexion and range of motion ) .
Concerning perioperative data , the MSV evidence d the shortest hospital stay , while the MPP the shortest surgical duration and lowest estimated blood loss .
According to the main findings of the present study , the mini-subvastus approach for total knee arthroplasty demonstrated superior overall compared to the other approaches .
Alternatives to the classical medial parapatellar ( MPP ) approach for total knee arthroplasty ( TKA ) include the mini-medial parapatellar ( MMPP ) , mini-subvastus ( MSV ) , mini-midvastus ( MMV ) and quadriceps-sparing ( QS ) approaches .
The best approach has been not fully clarified .
The purpose of the present study was to conduct a Bayesian network meta- analysis comparing these approaches .