[Influence of the surgical approach on postoperative rehabilitation after TKA].
BACKGROUND
Minimising the soft tissue trauma and early rehabilitation are among the major aims using the MIS technique in joint replacement.


OBJECTIVE
The aim of this prospective randomised study is to compare the results after TKA using an MIS approach versus a standard approach.


METHODS
We compared 30 TKA using a mini-midvastus approach (MIS group) with 30 conventionelly performed TKA using a midvastus approach (control group). In all cases the same implants (NexGen LPS) were used. The Knee Society score (KSS), an activity score, the visual analogue scale, myoglobin and creatinine kinase as well as the blood loss were measured up to 12 weeks postoperatively. Implant positioning was evaluated using the Knee Society Roentgenographic evaluation and scoring system.


RESULTS
Advantages of the MIS group were measured in KSS and activity score up to 12 weeks postoperatively. The increase of myoglobin and creatinine kinase was lower in the MIS group up to 24 hours or 72 hours, respectively. No differences were found comparing the implant positioning and blood loss.


CONCLUSIONS
The MIS technique in TKA with minimisation of the soft tissue trauma leads to better clinical and functional results in the early postoperative time and does not modify the implant positioning.
Wohlrab
D
D
Zentrum für Erkrankungen der Haltungs- und Bewegungsorgane, Klinik und Poliklinik für Orthopädie und Physikalische Medizin, Martin-Luther-Universität Halle-Wittenberg, Halle. david.wohlrab@medizin.uni-halle.de
Gutteck
N
N
Hildebrand
M
M
Zeh
A
A
Hein
W
W
D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D016063:Blood Loss, Surgical / Q000517:prevention & control; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009211:Myoglobin / Q000097:blood; D010147:Pain Measurement; D011183:Postoperative Complications / Q000097:blood / Q000534:rehabilitation*; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology
D009211:Myoglobin; D003402:Creatine Kinase