Clinical and radiographic outcomes of minimally invasive total  knee arthroplasty through a lateral approach

Clinical and radiographic outcomes of minimally invasive total knee arthroplasty through a lateral approach

  • نوع فایل : کتاب
  • زبان : انگلیسی
  • مؤلف : Yasuo Niki • Hideo Matsumoto • Akihiro Hakozaki • Hiroya Kanagawa • Yoshiaki Toyama • Yasunori Suda
  • چاپ و سال / کشور: 2010

Description

Purpose With increasing confidence and surgical experience, minimally invasive surgery (MIS) in total knee arthroplasty (TKA) is now being applied to more complicated cases. The present study assessed the feasibility of MIS-TKA using a lateral approach for valgus knees. Methods Subjects comprised 26 patients with valgus knees who underwent MIS-TKA using a lateral subvastus approach. Five cases required a 1-cm snip of vastus lateralis obliquus, to shift the patella medially without eversion. Clinical scores and radiographic parameters of lateral MIS-TKA were examined and compared with those of 26 medial MIS-TKAs matched for preoperative patient characteristics. Results The lateral MIS-TKA group showed slightly longer operative time and larger skin incision than the medial MIS-TKA group. Nevertheless, myoglobin index and pain on a visual analog scale on postoperative day 7 were significantly lower in the lateral MIS-TKA group than in the medial MIS-TKA group. Postoperative improvement of clinical scores was quite comparable between lateral and medial MIS-TKA groups. Radiographic assessment revealed that tibiofemoral mechanical axis aligned within ±3 from ideal in 24 of 26 patients after lateral MIS-TKA. MIS technique-related complications occurred in only 1 patient presenting with subsidence of the tibial component, due to malpositioning of the tibial component. Conclusion From the perspectives of postoperative pain, clinical scores, radiographic accuracy, and postoperative complication rate, lateral MIS-TKA achieved comparable or superior results to medial MIS-TKA. This technique may offer a promising technical option that can be utilized for most patients with valgus knee deformity.
Knee Surg Sports Traumatol Arthrosc (2011) 19:973–979 DOI 10.1007/s00167-010-1323-x Received: 10 March 2010 / Accepted: 25 October 2010 / Published online: 18 November 2010
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