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Complications after minimally invasive total knee arthroplasty as compared with traditional incision techniques: a
Rajiv Gandhi1, Holly Smith, Kelly A Lefaivre
1Division of Orthopaedic Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Canada.
Abstract:
The primary objective of our meta-analysis was to compare the incidence of complications between minimally invasive surgery and standard total knee arthroplasty (TKA) approaches. We reviewed randomized controlled trials comparing minimally invasive TKA to standard TKA. After testing for publication bias and heterogeneity, the data were aggregated by random effects modeling. Our primary outcome was the number of complications. Our secondary outcomes were alignment outliers, Knee Society Function scores, and Knee Society Knee scores. The combined odds ratios for complications for the minimally invasive surgery group and alignment outliers were 1.58 (95% confidence interval, 1.01-2.47; P < .05) and 0.79 (95% confidence interval, 0.34-1.82; P = .58), respectively. The standard difference in means for Knee Society scores was no different between groups. Minimally invasive knee surgery should be approached with caution.
Insights
Minimally invasive knee surgery shows a higher incidence of complications compared to standard total knee arthroplasty (TKA). Surgeons should exercise caution when considering minimally invasive TKA due to potential risks.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Clinical Research
Background:
- Total knee arthroplasty (TKA) is a common procedure for knee osteoarthritis.
- Minimally invasive surgery (MIS) approaches aim to reduce surgical trauma.
- Comparative data on complication rates between MIS TKA and standard TKA are crucial for clinical decision-making.
Purpose of the Study:
- To compare the incidence of complications between minimally invasive surgery and standard total knee arthroplasty (TKA).
- To evaluate secondary outcomes including alignment outliers and functional knee scores.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs).
- Inclusion of studies comparing MIS TKA versus standard TKA.
- Random effects modeling used for data aggregation after assessing publication bias and heterogeneity.
Main Results:
- A statistically significant increased odds ratio for complications was observed in the minimally invasive surgery group (OR=1.58, P < .05).
- No significant difference in alignment outliers between MIS TKA and standard TKA (OR=0.79, P = .58).
- Knee Society scores showed no significant difference between the two surgical approaches.
Conclusions:
- Minimally invasive knee surgery is associated with a higher incidence of complications compared to standard TKA.
- Current evidence suggests that minimally invasive knee surgery should be approached with caution.
- Further research may be needed to refine MIS TKA techniques and patient selection.