Results of the 136 consecutive minimally invasive total knee arthroplasties.

The authors evaluated results of 136 consecutive minimally invasive total knee arthroplasties (MIS TKAs). The first 22 knees, performed with strict patient selection criteria, were determined as a learning experience. According to results of the next 114 knees, the average wound length was 9.2 centimeters and the average blood loss was 470 milliliters. At a mean follow-up of 14 months, the mean Knee Society score improved from 37.5 to 96 points with 96.3% of excellent results. Sixty-five knees, group A, had within 10 degrees of varus and 49 knees, group B, had more deformity. Clinical results of both groups were not statistically different in terms of operative time, blood loss, pain score, postoperative knee flexion at 2 weeks and 6 months and postoperative day of walking. However, the ability to straighten the knee was significantly delayed in knees with more deformity (group B). After gaining learning curve, surgeons could extend performing MIS TKA in patients with more knee deformity.

Rapid ambulation and range of motion after minimally invasive total knee arthroplasty.

The authors evaluated the intraoperative data and early clinical results of 22 minimally invasive mini-incision total knee arthroplasties (mini-incision TKAs) performed between October 2002 and September 2003. Results were matched with 22 patients who underwent standard TKA in the same period. At a minimum 12-week follow up, results comparing the mini-incision TKA group and the standard TKA group were evaluated as follows: The average operative time was 137.1 vs 115.8min (p=0.02), the average wound length was 9.4 vs 13.7 cm, the average blood loss was 456 vs 512 ml (p=0.14) and the number of patients who could start to walk on postoperative day one was 17 vs 2. On postoperative day one, 82% of the mini-incision TKA group could do active knee extension meanwhile none of the standard group could. Postoperative pain score was not different at 24 hours or 48 hours. At 2 and6 weeks, the mini-incision TKA group had less pain with significant difference (p=0.002 and p=0.002). The postoperative range of motion in the mini-incision group was also significantly improved at 2 weeks (p=0.03). However, pain and range of motion were not different in both groups after 12 weeks. Early results of mini-incision TKA accelerated patient postoperative activity, ambulation and range of motion.

Contralateral total knee arthroplasty after unilateral surgery in bilateral varus gonathrosis.

The authors retrospectively evaluated the rate of contralateral total knee arthroplasty (TKA) in 93 patients who had bilateral varus gonarthrosis and underwent unilateral TKA. Patients were divided into 3 groups according to degree of anatomical varus of the contralateral knee and/or contralateral knee pain at the time of first TKA. Group A, 25 patients, had no pain and within 10-degree deformity. Group B, 48 patients, had pain and within 10-degree deformity. Group C, 20 patients, had pain and more than 10-degree deformity. At a minimum of 2-years follow up after the first TKA, the mean function scores among the groups were significantly different (p < 0.0001). Seventy-five percent of group C, 34% of group B and 0% of group A underwent sequential contralateral TKA, respectively at average 6.7-month interval. Rate of contralateral TKA was high if patients had contralateral knee pain and more than 10 degrees of anatomical varus.