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

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.