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 .
Five-year follow-up of minimally invasive computer assisted total knee arthroplasty (MICATKA) versus conventional computer assisted total knee arthroplasty (CATKA) - A population matched study.
BACKGROUND Minimally invasive surgery ( MIS ) has perceived advantages in the early post-operative stage such as reduced blood loss , decreased pain , earlier return to function and earlier discharge . The aim of our study was to confirm that longer term clinical outcome of TKA is not compromised when MIS is combined with computer assisted surgery . METHODS Eighty patients matched for age , gender , pre-operative Knee Society Score ( KSS ) and mechanical axis were prospect ively studied . Forty patients underwent minimally invasive computer assisted total knee arthroplasty ( MICATKA ) and 40 patients underwent conventional computer assisted TKA ( CATKA ) .  Functional scores were determined at 6 weeks , 6 , 12 , 18 , and 24 months and 5 years post-surgery . Long-leg alignment views were obtained 3 months post-operatively . RESULTS KSSs in the short term were significantly better in the MICATKA group than in the CATKA group ( p<000.1 ) . Tourniquet-time was 58 min in the MICTKA group and 60 min in the CATKA group ( p=0.3 ) . Straight leg raise was achieved by day one in 93 % of the MICATKA group compared to 30 % of the CATKA group ( p<0.001 ) . Length of stay for the MICATKA group has a mean of 3.25 days and a mean of 6 days for the CATKA group ( p<0.001 ) . KSSs up to 2-years were significantly better in the MICTKA group ( p<0.001 ) . At 5-years there was no significant difference in KSSs ( p=0.46 ) in the MICATKA and CATKA groups . CONCLUSION We confirm that the use of navigation in minimally invasive TKA permits a number of early post-operative advantages and that longer-term functional outcome is not compromised with its usage . LEVEL OF EVIDENCE Level II
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 .