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A PROSPECTIVE RANDOMISED TRIAL COMPARING MINIMAL INVASIVE AND STANDARD PARAPATELLAR APPROACHES FOR UNICOMPARTMENTAL ARTHROPLASTY



Abstract

AIMS: To compare a randomised group of patients undergoing UKA to investigate the advantages of the minimal invasive approach in the early post-operative stage.

METHODS & RESULTS: 100 patients on the waiting list for UKA were recruited into the trial. Patients were randomised into 2 groups: Group 1 – longitudinal skin incision with dislocation of the patella, Group 2 – the minimally invasive approach. Standard milestones were recorded post-operatively: time to achieve IRQ, independent stair climbing and to discharge. Additionally, patients were scored with the AKSS and Oxford knee questionnaire pre-operatively, at 6 weeks, 6 months and 1 year.

No significant differences were found between the 2 groups in the measured parameters.

CONCLUSION: To our knowledge, there has been no previous randomised trial to investigate the results of less invasive surgery for UKA. We have been unable to demonstrate a significant advantage of this approach. With the continued drive for early return to function, some centres incorporate a 24hr accelerated discharge protocol. The less invasive approach may make this more achievable. We recommend however that the surgical procedure and implant position must not be compromised for the benefit of rapid discharge to the deficit of long term results.

Correspondence should be addressed to Mr Tim Wilton, BASK at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.