title: Minimally invasive surgery (MIS) for total knee replacement; medium term results with minimum five year follow-up.
abstract: BACKGROUND
  MIS TKA has been shown to offer a reduced in-patient stay, but no clinical difference at two years. Whilst there may be a benefit from earlier discharge, we need to ensure that there are no detrimental effects in the medium and long-term following MIS-TKA. To report the mid-term result from a prospective randomised controlled trial (RCT) comparing MIS-TKA with standard approach for TKA.
  
  
  METHODS
  Using knee score questionnaires, we collected patient reported outcome measures (PROMs) regarding pain and function. Sixty-six patients (from an eligible cohort of 83 patients) completed the mid-term postal follow-up.
  
  
  RESULTS
  There was no significant difference between groups for change in score from pre-operative to final follow-up in all three PROMs. Mean MIS and standard group improvement was: AKSS 53 and 51 (p=0.7644), OKS 15 and 16 (p=0.2341) or WOMAC 15 and 15 (p=0.9900) respectively. Both groups showed improvement in pain and function with no significant difference between groups. There was no difference between groups for revision due to malalignment at a mean six year follow-up.
  
  
  CONCLUSIONS
  In addition to the early benefits regarding hospital stay and complications, we have found that at a mean of six years there was no increase in malalignment, pain or function with MIS techniques.
authors.affiliation: University of Bristol, Senate House, Tyndall Avenue, BS8 1TH Bristol, United Kingdom. Electronic address: ou0794@my.bristol.ac.uk.
authors.forename: Olivia
authors.initials: O
authors.lastname: Unwin
authors.affiliation: Bristol Knee Group, Avon Orthopaedic Centre, Southmead Hospital, BS10 5NB Bristol, United Kingdom. Electronic address: mahassaballa@gmail.com.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Hassaballa
authors.affiliation: Bristol Knee Group, Avon Orthopaedic Centre, Southmead Hospital, BS10 5NB Bristol, United Kingdom. Electronic address: james.murray@nbt.nhs.uk.
authors.forename: James
authors.initials: J
authors.lastname: Murray
authors.affiliation: Bristol Knee Group, Avon Orthopaedic Centre, Southmead Hospital, BS10 5NB Bristol, United Kingdom. Electronic address: william.harries@nbt.nhs.uk.
authors.forename: William
authors.initials: W
authors.lastname: Harries
authors.affiliation: Bristol Knee Group, Avon Orthopaedic Centre, Southmead Hospital, BS10 5NB Bristol, United Kingdom. Electronic address: andrew.porteous@nbt.nhs.uk.
authors.forename: Andrew
authors.initials: A
authors.lastname: Porteous
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D000071066:Patient Reported Outcome Measures; D011446:Prospective Studies
keywords: Knee; Mini-mid vastus; Minimally invasive surgery; Subvastus; Total knee arthroplasty