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Volume 21, Issue 2, Pages 92-96 (June 2010)


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Minimally Invasive Surgery Is Not a Risk Factor of Early Total Knee Arthroplasty Failure

Adolph V. Lombardi Jr., MD, FACS§Corresponding Author Informationemail address, Keith R. Berend, MD§, Joanne B. Adams, BFA

Minimally invasive surgery (MIS) techniques have been developed with the goal of reducing recovery and improving outcomes. Critics argue that MIS reduces visualization and compromises technique, causing wound problems secondary to surgical trauma and increasing early failure. To determine whether MIS techniques lead to increased complications and early revisions, we reviewed our experience using a limited medial parapatellar approach in 3631 primary total knee arthroplasties (TKA) since 2003, in comparison with a historic control of 1291 primary TKA performed in 1994-1996 using a standard medial parapatellar approach. Fewer MIS than standard TKA required manipulation (5.4% vs 8.9%; P = 0.0001), had complications requiring reoperation (1.0% vs 2.1%; P = 0.0047), and required revision of one or more component parts for any reason (0.8% vs 4.4%; P = 0.0000). In our experience with more that 3600 primary MIS TKA with a rapid recovery protocol, excellent outcomes have been seen at up to 6 years follow-up, with a concomitant reduction compared with standard approach TKA in rates of manipulation and early complications requiring reoperation.

 Joint Implant Surgeons, Inc., New Albany, OH, USA

 Department of Orthopaedics, Ohio State University, Columbus, OH, USA

 Department of Biomedical Engineering, Ohio State University, Columbus, OH, USA

§ Mount Carmel Health System, Columbus, OH, USA

Corresponding Author InformationAddress reprint requests to Adolph V. Lombardi Jr., MD, FACS, Joint Implant Surgeons, Inc, 7277 Smith's Mill Road, Suite 200, New Albany, Ohio 43054

 Competing interests. Some of the authors (A.V.L. and K.R.B.) have received payments from a company related to products discussed or presented in this study (Biomet, Inc.).

PII: S1045-4527(09)00102-3

doi:10.1053/j.sart.2009.12.016


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