title: Minimally invasive and standard total knee arthroplasty result in similar clinical outcomes at a minimum of five-year follow-up.
abstract: BACKGROUND
  Although a minimally invasive total knee arthroplasty (MIS-TKA)fails to show superior short-term clinical results over a standard technique, the longer-term outcomes remain unknown.
  
  
  OBJECTIVE
  Evaluate the intermediate clinical outcomes of MIS-TKA, comparing to those of standard technique.
  
  
  METHODS
  The authors retrospectively collected data from the patients who underwent uncomplicated total knee arthroplasty between March 2004 and December 2005. Patients with a body mass index (BMI) over 30 kg/m2 or with severe deformity and those who required a complex surgical procedure were excluded. Patients were divided into 2 groups based on the surgical approach: 27patients (31 knees) and 26 patients (33 knees) for the MIS-TKA and standard TKA, respectively. Pre- and perioperative data were collected. Clinical and functional outcomes were followed-up to a minimum of 5 years.
  
  
  RESULTS
  The means follow-up in the MIS- and standard TKA groups were 73 and 74 months, respectively. Pre- and perioperative data did not show any differences between the two groups except for more females and lower BMI in the MIS-TKA group. At 2- and 5-year post-operative follow-up, the knee society pain and functional scores improved significantly in both groups (p < 0.001). There were no differences in the postoperative alignment, range of motion and the knee society scores between MIS- and standard TKA. In addition, post-operative complications were similar in both groups (2 manipulations under anesthesia and 1 traumatic rupture of patellar tendon in each group).
  
  
  CONCLUSIONS
  The present study showed that there were no differences in the intermediate-term post-operative function between MIS-TKA and standard TKA in a well-selected patient population. Thus, orthopedic surgeons should not compromise their surgical exposure by using small and unfamiliar surgical technique. Since MIS-technique may increase the postoperative complication rate, a long-term study to evaluate the results of MIS-TKA is still needed.
authors: Department of Orthopaedic Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. uaasis@gmail.com
authors: Aasis
authors: A
authors: Unnanuntana
authors: Chaturong
authors: C
authors: Pornrattanamaneewong
authors: Christopher S
authors: CS
authors: Mow
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D011183:Postoperative Complications; D016896:Treatment Outcome