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RADIOGRAPHIC ASSESSMENT OF MINI INCISION TOTAL KNEE REPLACEMENT



Abstract

Purpose: X-Ray analysis of a subset of TKR’s performed using the mini-incision technique has been undertaken to assess the accuracy of alignment, as TKR through limited exposure lends itself to a potential risk of mal-positioning of the components.

Methods and Results: The limited exposure afforded by the small skin incision and mid-vastus approach in the new technique of Mini Incision TKR, has a potential for increasing the risk of mal positioning components without the use of navigation systems. 128 mini-incision TKR’s have to date of submission, been undertaken in 125 patients (67F: 58M: mean age 72: mean BMI 29). A prospective assessment of these patients has been ongoing since its introduction in November 2003. The mean hospital stay is 5.5 days and mean range of flexion at six weeks is 106°. Two patients have required manipulation under anaesthetic for poor flexion at six weeks and blood transfusion has only been required in 4%. In patients with a minimum 6 months follow up, long leg alignment X-rays have shown the mechanical axis to be within 3° of normal in 4/5.

Conclusion: We believe that Mini Incision TKR is a safe reliable and reproducible technique offering substantial savings to the patient and health service without compromising accuracy.

Honorary Secretary – Mr Roger Smith. Correspondence should be addressed to BASK at the Royal College of Surgeons, 35 - 43 Lincoln’s Inn Fields, London WC2A 3PN