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Archives of Orthopaedic and Trauma Surgery

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01-01-2014 | Knee Arthroplasty

Minimal invasive and computer-assisted total knee replacement compared with the minimal invasive technique: a prospective, randomized trial with short-term outcomes

Authors: Zhenxiang Zhang, Beibei Gu, Wei Zhu, Lixian Zhu, Qingsong Li, Yaqing Du

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 1/2014

Abstract

Introduction

Up to now, no prospective, randomized comparisons between minimal invasive and computer-assisted total knee arthroplasty (MICA-TKA), and minimal invasive technique (MI-TKA) has been documented to evaluate not only clinical, but also radiologic results of the MICA-TKA. This prospective, randomized study was performed to compare the short-term results of MICA-TKA with minimal invasive technique MI-TKA for 6-month follow-up.

Patients and methods

We reported the clinical and radiological results of 80 subjects who had cruciate-substituting, TKA-implanted primary total knee arthroplasties using either minimal invasive and computer-assisted technique (40 patients Group I) or minimal invasive technique (40 patients, Group II). Tourniquet time, length of skin incision, and total blood loss were compared. Knee society scores (KSSs), knee society functional scores (KSFSs), range of motion (ROM), and radiographic results were assessed and reported preoperatively and at 6-month follow-up.

Results

The accuracy of the implantations in relation to the coronal mechanical axis in Group I was superior to that of Group II (P < 0.05). The femoral rotational profile revealed the prosthesis in Group I that was implanted with significantly less internal rotation than in Group II. The average blood loss in patients of Group I was significantly reduced as compared to patients of Group II. No significant difference was detected in terms of tourniquet time or length of skin incision. Clinical results, with regard to ROMs and KSSs, as well as KSFSs were equally good in both the groups.

Conclusions

Better alignment and similarity of good clinical results at short-term follow-up may provide subjects who receive MICA-TKA with long-term endurance of their implants. Further studies on longer-term outcomes and functional improvements are required to validate these possibilities.

Yeoh D, Nicolaou N, Goddard R et al (2012) Manipulation under anaesthesia post total knee replacement: long term follow up. Knee 19:329–331PubMedCrossRef

Hopley CD, Crossett LS, Chen AF (2013) Long-term clinical outcomes and survivorship after total knee arthroplasty using a rotating platform knee prosthesis: a meta-analysis. J Arthroplast 2:68–77CrossRef

Huizinga MR, Brouwer RW, Bisschop R et al (2012) Long-term follow-up of anatomic graduated component total knee arthroplasty: a 15- to 20-year survival analysis. J Arthroplast 27:1190–1195CrossRef

Gandhi R, Dhotar H, Razak F et al (2010) Predicting the longer term outcomes of total knee arthroplasty. Knee 17:15–18PubMedCrossRef

Ma HM, Lu YC, Ho HY et al (2005) Long-term results of total condylar knee arthroplasty. J Arthroplast 20:580–584CrossRef

Zhang ZX, Zhu W, Gu BB et al (2013) Mini-midvastus versus mini-medial parapatellar approach in total knee arthroplasty: a prospective, randomized study. Arch Orthop Trauma Surg 133:389–395PubMedCrossRef

Nestor BJ, Toulson CE, Backus SI (2010) Mini-midvastus vs. standard medial parapatellar approach: a prospective, randomized, double-blinded study in patients undergoing bilateral total knee arthroplasty. J Arthroplast 25:5–11CrossRef

Berger RA, Sanders S, Gerlinger T et al (2005) Outpatient total knee arthroplasty with a minimally invasive technique. J Arthroplast 20:33–38CrossRef

Lonner JH (2006) Minimally invasive approaches to total knee arthroplasty: results. Am J Orthop 35:27–29PubMed

10.

Tenholder M, Clarke HD, Scuderi GR (2005) Minimal-incision total knee arthroplasty: the early clinical experience. Clin Orthop Relat Res 440:67–76PubMedCrossRef

11.

Dalury DF, Dennis DA (2005) Mini-incision total knee arthroplasty can increase risk of component malalignment. Clin Orthop Relat Res 440:77–81PubMedCrossRef

12.

Berend ME, Ritter MA, Meding JB et al (2004) Tibial component failure mechanisms in total knee arthroplasty. Clin Orthop Relat Res 428:26–34PubMedCrossRef

13.

Weng YJ, Wei Hsu RW, Hsu WH (2009) Comparison of computer-assisted navigation and conventional instrumentation for bilateral total knee arthroplasty. J Arthroplast 24:668–673CrossRef

14.

Carter RE III, Rush P, Smid JA et al (2008) Experience with computer-assisted navigation for total knee arthroplasty in a community setting. J Arthroplast 23:707–713CrossRef

15.

Bové JC (2010) Computer-assisted total knee arthroplasty: does the tibial component remain at malposition risk? Orthop Traumatol Surg Res 96:536–542PubMedCrossRef

16.

O’Malley MJ, Klatt BA (2012) Computer-assisted navigation-total knee arthroplasty. Oper Tech Orthop 22:176–181CrossRef

17.

Swank ML, Lehnert IE (2005) Orthopedic personnel roles in the OR for computer-assisted total Knee arthroplasty. AORN J 82:631–632PubMedCrossRef

18.

Seon JK, Song EK (2005) Functional impact of navigation-assisted minimally invasive total knee arthroplasty. Orthopedics 10:1251–1254

19.

Seon JK, Song EK (2006) Navigation-assisted less invasive total knee arthroplasty compared with conventional total knee arthroplasty: a randomized prospective trial. J Arthroplast 21:777–782CrossRef

20.

Confalonieri N, Manzotti A, Pullen C et al (2007) Mini-incision versus mini-incision and computer-assisted surgery in total knee replacement: a radiological prospective randomised study. Knee 14:443–447PubMedCrossRef

21.

Hart R, Janecek M, Cizmar I et al (2006) Minimally invasive and navigated implantation for total knee arthroplasty: X-ray analysis and early clinical results. Orthopade 35:552–557PubMedCrossRef

22.

Seon JK, Song EK, Yoon TR et al (2007) Comparison of functional results with navigation-assisted minimally invasive and conventional techniques in bilateral total knee arthroplasty. Comput Aided Surg 12:189–193PubMed

23.

Lüring C, Beckmann J, Haiböck P et al (2008) Minimal invasive and computer assisted total knee replacement compared with the conventional technique: a prospective, randomised trial. Knee Surg Sports Traumatol Arthrosc 16:928–934PubMedCrossRef

24.

Lee DH, Choi J, Nha KW et al (2011) No difference in early functional outcomes for mini-midvastus and limited medial parapatellar approaches in navigation-assisted total knee arthroplasty: a prospective randomized clinical trial. Knee Surg Sports Traumatol Arthrosc 19:66–73PubMedCrossRef

25.

Tenholder M, Clarke HD, Scuderi GR (2005) Minimal-incision total knee arthroplasty: the early clinical experience. Clin Orthop 440:67–76PubMedCrossRef

26..

Tokuhara Y, Kadoya Y, Kanekasu K et al (2006) Evaluation of the flexion gap by axial radiography of the distal femur. J Bone Joint Surg Br 88-B:1327–1330CrossRef

27.

Pang HN, Ee G, Lo NN et al (2012) Minimally invasive unicondylar knee arthroplasty in a patellectomized patient. Knee Surg Sports Traumatol Arthrosc 20:1831–1833PubMedCrossRef

28.

Tria AJ Jr (2010) Bicompartmental arthroplasty of the knee. Instr Course Lect 59:61–73PubMed

29.

Siramanakul C, Sriphirom P (2012) Comparison of clinical and radiographic outcomes between minimally invasive lateral approach and mini-midvastus approach in total knee arthroplasty. J Med Assoc Thai 10:53–57

30.

Costa CR, Johnson AJ, Harwin SF et al (2013) Critical review of minimally invasive approaches in knee arthroplasty. J Knee Surg 26:41–50PubMedCrossRef

31.

Ritterman S, Rubin LE et al (2013) Rehabilitation for total joint arthroplasty. R I Med J 96:19–22

32.

Wilson CJ, Fitzgerald B, Tait GR (2003) Five year review of the rotaglide total knee arthroplasty. Knee 10:167–171PubMedCrossRef

33.

Bindelglass DF, Dorr LD (1998) Current concepts review: symmetry versus asymmetry in the design of total knee femoral components-An unresolved controversy. J Arthroplast 13:939–944CrossRef

34.

Avci CC, Gülabi D, Erdem M et al (2013) Minimal invasive midvastus versus standard parapatellar approach in total knee arthroplasty. Acta Orthop Traumatol Turc 47:1–7PubMedCrossRef

35.

Bonutti PM, Zywiel MG, Ulrich SD et al (2010) Minimally invasive total knee arthroplasty: pitfalls and complications. Am J Orthop 39:480–484PubMed

36.

Kolisek FR, Bonutti PM, Hozack WJ (2007) Clinical experience using a minimally invasive surgical approach for total knee arthroplasty: early results of a prospective randomized study compared to a standard approach. J Arthroplast 22:8–13CrossRef

37.

Tria AJ Jr, Coon TM (2003) Minimal incision total knee arthroplasty: early experience. Clin Orthop Relat Res 416:185–190PubMedCrossRef

38.

Zanasi S (2011) Innovations in total knee replacement: new trends in operative treatment and changes in peri-operative management. Eur Orthop Traumatol 2:21–31PubMedCentralPubMedCrossRef

39.

Nizard R (2010) Evolution of care of patients needing a total knee replacement. Presse Med 39:1189–1193PubMedCrossRef

40.

Kumar N, Saleh J, Gardiner E et al (2000) Plugging the intramedullary canal of the femur in total knee arthroplasty. J Arthroplast 15:947–949CrossRef

41.

Raut VV, Stone MH, Wroblewski BM (1993) Reduction of postoperative blood loss after press-fit condylar knee arthroplasty with use of a femoral intramedullary plug. J Bone Joint Surg Am 75:1356–1357PubMed

42.

Ko PS, Tio MK, Tang YK et al (2003) Sealing the intramedullary femoral canal with autologous bone plug in total knee arthroplasty. J Arthroplast 18:6–9CrossRef

43.

Khanna A, Gougoulias N, Longo UG et al (2009) Minimally invasive total knee arthroplasty: a systematic review. Orthop Clin N Am 40:479–489CrossRef

Title: Minimal invasive and computer-assisted total knee replacement compared with the minimal invasive technique: a prospective, randomized trial with short-term outcomes
Authors: Zhenxiang Zhang
Beibei Gu
Wei Zhu
Lixian Zhu
Qingsong Li
Yaqing Du
Publication date: 01-01-2014
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 1/2014
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-013-1879-2

2024 ASCO Annual Meeting

Springer Medicine

Minimal invasive and computer-assisted total knee replacement compared with the minimal invasive technique: a prospective, randomized trial with short-term outcomes

Abstract

Introduction

Patients and methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Introduction

Patients and methods

Results

Conclusions

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