Open AccessBetter outcomes after minimally invasive surgeries compared to the standard invasive medial parapatellar approach for total knee arthroplasty: a meta‐analysis
Author(s) -
Migliorini Filippo,
Eschweiler Jörg,
Baroncini Alice,
Tingart Markus,
Maffulli Nicola
Publication year - 2021
Publication title -
knee surgery, sports traumatology, arthroscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.806
H-Index - 125
eISSN - 1433-7347
pISSN - 0942-2056
DOI - 10.1007/s00167-020-06306-9
Subject(s) - medicine , meta analysis , invasive surgery , total knee arthroplasty , blood loss , range of motion , surgery , randomized controlled trial , arthroplasty , physical therapy
Purpose Minimally invasive surgery (MIS) for total knee arthroplasty (TKA) is often marketed as being able to speed up healing times over standard invasive surgery (SIS) through the medial parapatellar approach. The advantages of these minimally invasive approaches, however, are not yet definitively established. A meta‐analysis of studies comparing peri‐operative and post‐operative differences and long‐term complications of MIS versus SIS for TKA was conducted. Methods This meta‐analysis was conducted following the PRISMA guidelines. The Pubmed, Google Scholar, Scopus, and Embase databases were accessed in September 2020. All clinical trials comparing minimally‐invasive versus standard approaches for TKA were considered. Only studies reporting quantitative data under the outcomes of interest were included. Methodological quality assessment was performed using the PEDro appraisal score. Results This meta‐analysis covers a total of 38 studies (3296 procedures), with a mean 21.3 ± 24.3 months of follow‐up. The MIS group had shorter hospitalization times, lower values of total estimated blood loss, quicker times of straight‐leg raise, greater values for range of motion, higher scores on the Knee Society Clinical Rating System (KSS) and its related Function Subscale (KSFS). Pain scores, anterior knee pain and revision rate were similar between MIS and SIS. SIS allowed a quicker surgical duration. Conclusion The present meta‐analysis encourages the use of minimally invasive techniques for total knee arthroplasty. However, MIS TKA is technically demanding and requires a long learning curve. Level of evidence III, meta‐analysis of clinical trials.