Minimally Invasive Total Knee Arthroplasty with Mini-midvastus Approach

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  • ＭＩＳ‐ＴＫＡの適応と限界　　Ｍｉｎｉ‐ｍｉｄｖａｓｔｕｓ　ａｐｐｒｏａｃｈによるＭＩＳ‐ＴＫＡ

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Abstract

Purpose: Minimally invasive surgery for TKA has been used in our institute since April, 2004. Our concept of MIS-TKA includes 1) to be performed by general orthopaedic surgeons, 2) not to insist on a small incision, 3) to be performed for all cases, 4) to minimize invasion to the extensor mechanism without patellar eversion. The purpose of this study is to evaluate the early results of MIS-TKA performed with the mini-midvastus approach, in comparison with conventional TKA with the midvastus approach.<BR>Methods: From January, 2003 to March, 2004, 57 consecutive TKA were performed with the conventional midvautus approach (the Standard group) . From April, 2004 to October, 2005, 60 MIS-TKA were performed (the MIS group) . We used the GENESIS II posterior stabilized knee (Smith & Nephew, Memphis, USA) and the Bi-surface knee (JMM, Osaka) .<BR>Results: Mean hospital stay was significantly shorter in the MIS group than in the Standard group. There were no significant differences in recovery of ROM, amount of total bleeding, or postoperative knee alignment.<BR>Conclusion: MIS-TKA with the mini-midvastus approach could be indicated for almost all patients undergoing TKA and resulted in early recovery after TKA. Recognition of error patterns seems very important for the procedure, because there was a learning curve noted in our results. Preoperative simulation with the 3D-template software would be useful for MIS-TKA.

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