There was no significant difference in the outliers on complications , knee flexion , and postoperative functional scores .
Coronal plane tibial component showed statistically significant number of outliers in the MIS group demonstrating superior component positioning in the MIS CA group .
Computer-assisted minimally invasive TKA is superior than the st and ard MIS TKA in terms of component positioning ; however , it is unclear if this will have any long-term clinical implication s. The increased operative time , although clinical ly relevant , does not appear to be associated with an increase in complications
BACKGROUND Median parapatellar approach is the most used for total knee arthroplasty ( TKA ) .
With the advent of enhanced recovery and shorter length of hospital stay , there is an increasing pressure on surgeons to perform surgery through smaller incisions .
Minimally invasive ( MIS ) TKA allows earlier functional recovery ; it is not clear if this is associated with more complications .
It is also unclear if computer-assisted minimally invasive ( MIS CA ) TKA has any affect on improving patient outcomes .
We performed a systematic review and meta- analysis comparing MIS CA vs MIS TKA .
Comparison of two minimally invasive implantation instrument-sets for total knee arthroplasty
Several choices of instrument systems are available for minimally invasive surgical approaches . There are reports that one alternative , the quadriceps sparing , side-cutting instrumentation , results in diminished implantation accuracy . A total of 108 patients were r and omized to undergo TKA either using side-cutting implant instrumentation ( Group A ) or anterior – posterior mini-incision instrumentation ( Group B ) . All TKAs were operated on with a minimal invasive , mini-midvastus surgical approach . 50 % of the TKAs were performed with computer-assistance in each cohort . The radiographic parameters , clinical outcomes and knee scores were evaluated preoperatively and 3 months postoperative . In Group B , we found significantly higher accuracy for the mechanical axis of the limb ( range ±3 ° : Group A 54 % versus Group B 89 % , p = < 0.001 ) , medial proximal tibial angle ( range ±3 ° : Group A 85 % versus Group B 98 % , p = < 0.027 ) and tibial slope ( range ±3 ° : Group A 59 % versus Group B 85 % , p = < 0.007 ) . The application of the navigation system could only significantly reduce outliers ( accuracy > 3 ° ) in Group B. Clinical outcomes and knee scores were similar in both groups and were not influenced by computer-assistance . Using the anterior – posterior , mini-incision instruments for minimally invasive TKA will lead to higher implantation accuracy when compared to the quadriceps sparing side-cutting instrumentation . The navigation technique could not compensate for shortcomings of the side-cutting instrumentation . The clinical relevance of this study is that the quadriceps sparing side-cutting instrumentation should not be used for TKA because of unacceptable reduced implantation accuracy
There was no significant difference in the outliers on complications , knee flexion , and postoperative functional scores .
Coronal plane tibial component showed statistically significant number of outliers in the MIS group demonstrating superior component positioning in the MIS CA group .
Computer-assisted minimally invasive TKA is superior than the st and ard MIS TKA in terms of component positioning ; however , it is unclear if this will have any long-term clinical implication s. The increased operative time , although clinical ly relevant , does not appear to be associated with an increase in complications
BACKGROUND Median parapatellar approach is the most used for total knee arthroplasty ( TKA ) .
With the advent of enhanced recovery and shorter length of hospital stay , there is an increasing pressure on surgeons to perform surgery through smaller incisions .
Minimally invasive ( MIS ) TKA allows earlier functional recovery ; it is not clear if this is associated with more complications .
It is also unclear if computer-assisted minimally invasive ( MIS CA ) TKA has any affect on improving patient outcomes .
We performed a systematic review and meta- analysis comparing MIS CA vs MIS TKA .