Abstract
Purpose To report on the results, surgical technique and issues with mini-incision total knee arthroplasty.
Methods and results The new technique of mini-incision total knee replacement entails the use of smaller cutting blocks and alignment jigs applied to the femur with minimal surgical exposure, achieved by subluxation of the patella laterally rather than full eversion of the extensor mechanism. The technique was carefully introduced in November 2003.
The results of the first 20 consecutive patients have been compared with 20 standard TKR procedures. The mean age of 73.5 and BMI of 29 was not significantly different to the standard Group. Mean hospital stay was approximately halved (5 days versus 9 days). 75% of patients were discharged on day 4 without needing extra home support. Mean incision length was 13.5cm and only one of 20 required blood transfusion. Mean operative time was 12 minutes longer and post-operative CT alignment showed no mal-position of the implants.
Conclusion Mini-incision TKR is a safe, reliable and reproducible method, allowing significant cost savings and benefits for the patients and hospital. Confidence needs to be gained in the reduced visibility of traditional landmarks and training of surgeons remains an issue.
Correspondence should be addressed to Roger Smith, Honorary Secretary, BASK c/o Royal College of Surgeons, 35 – 43 Lincoln’s Inn Fields, London WC2A 3PN
