Abstract
Introduction: The concept of minimally invasive total knee arthroplasty surgery evolved to reduce quadriceps muscle strength loss and improve clinical outcome following total knee replacement. We performed a systematic review of the published literature on Minimally Invasive Total Knee Arthroplasty (MITKA) and to analyse the reported surgical outcomes.
Material and Methods: A comprehensive search of databases using various combinations of the keywords: minimally invasive total knee arthroplasty, mini-incision total knee replacement and minimally invasive arthroplasty was performed. 28 studies published from January 2003 to June 2008 meeting the inclusion criteria were evaluated using the Coleman Methodology Score (CMS).
Results: AT A mean CMS of 60, most studies reporting on outcome of MITKA are of moderate scientific quality. Patients undergoing MITKA tend to have decreased post operative pain, rapid recovery of quadriceps function, reduced blood loss, improved range of motion (mostly reported as a short term gain) and shorter hospital stay in comparison to patients undergoing standard total knee arthroplasty. These benefits however need to be balanced against the incidence of increased tourniquet time and increased incidence of component malaligment in the MITKA group.
Conclusion: Evidence based knowledge regarding results of MITKA comes from prospective studies of moderate quality with short follow up periods. Multicenter studies with longer follow ups are needed to justify the long term advantages of MITKA over standard total knee arthroplasty.
Correspondence should be addressed to: EFORT Central Office, Technoparkstrasse 1, CH – 8005 Zürich, Switzerland. Email: office@efort.org
