A meta-analysis of minimally invasive and conventional medial parapatella approaches for primary total knee arthroplasty

Verfasser / Beitragende:
[Canfeng Li, Yi Zeng, Bin Shen, Pengde Kang, Jing Yang, Zongke Zhou, Fuxing Pei]
Ort, Verlag, Jahr:
2015
Enthalten in:
Knee Surgery, Sports Traumatology, Arthroscopy, 23/7(2015-07-01), 1971-1985
Format:
Artikel (online)
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024 7 0 |a 10.1007/s00167-014-2837-4  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s00167-014-2837-4 
245 0 2 |a A meta-analysis of minimally invasive and conventional medial parapatella approaches for primary total knee arthroplasty  |h [Elektronische Daten]  |c [Canfeng Li, Yi Zeng, Bin Shen, Pengde Kang, Jing Yang, Zongke Zhou, Fuxing Pei] 
520 3 |a Purpose: Minimally invasive surgical (MIS) approaches for total knee arthroplasty (TKA) have become increasingly popular for doctors and patients. They have argued that it decreases post-operative pain, accelerates functional recovery and increases patient satisfaction due to less injury. However, critics are concerned about TKA's possible effects on component position and with complications, considering the procedure's limited exposure. The purpose of this study was to summarise the best evidence in comparing the clinical and radiological outcomes between MIS and a conventional approach in TKA. Methods: Electronic databases were systematically searched to identify relevant randomised controlled trials (RCTs). Our search strategy followed the requirements of the Cochrane Library Handbook. Methodological quality was assessed, and data were extracted independently by two authors. Results: Thirty studies, including 2,536 TKAs, were reviewed: 1,259 minimally invasive and 1,277 conventional exposure TKAs. The results showed that while the MIS group had longer operation times and tourniquet times, it had superior outcomes in KSS (objective and total), range of motion, flexion range of motion, flexion 90° day, straight leg-raising day, total blood loss and decrease in haemoglobin. However, wound-healing problems occurred more frequently in the MIS group. There were no statistically significant differences in other clinical or radiological outcomes between the MIS and conventional groups in TKA. Conclusion: The preliminary results indicate that the MIS approach provides an alternative to the conventional approach, with earlier rehabilitation but no malpositioning or severe complications. Wound-healing problems can be treated easily and effectively, and the risk also decreases as surgeons become more experienced, and more user-friendly instruments are invented. Potential benefits in medium- and long-term outcomes require larger, multicentre and well-conducted RCTs to confirm. Level of evidence: Therapeutic study, Level II. 
540 |a Springer-Verlag Berlin Heidelberg, 2014 
690 7 |a Minimally invasive approach  |2 nationallicence 
690 7 |a Conventional approach  |2 nationallicence 
690 7 |a Total knee arthroplasty  |2 nationallicence 
690 7 |a Meta-analysis  |2 nationallicence 
700 1 |a Li  |D Canfeng  |u Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China  |4 aut 
700 1 |a Zeng  |D Yi  |u Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China  |4 aut 
700 1 |a Shen  |D Bin  |u Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China  |4 aut 
700 1 |a Kang  |D Pengde  |u Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China  |4 aut 
700 1 |a Yang  |D Jing  |u Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China  |4 aut 
700 1 |a Zhou  |D Zongke  |u Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China  |4 aut 
700 1 |a Pei  |D Fuxing  |u Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China  |4 aut 
773 0 |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/7(2015-07-01), 1971-1985  |x 0942-2056  |q 23:7<1971  |1 2015  |2 23  |o 167 
856 4 0 |u https://doi.org/10.1007/s00167-014-2837-4  |q text/html  |z Onlinezugriff via DOI 
898 |a BK010053  |b XK010053  |c XK010000 
900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a review-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s00167-014-2837-4  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Li  |D Canfeng  |u Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Zeng  |D Yi  |u Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Shen  |D Bin  |u Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Kang  |D Pengde  |u Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Yang  |D Jing  |u Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Zhou  |D Zongke  |u Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Pei  |D Fuxing  |u Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/7(2015-07-01), 1971-1985  |x 0942-2056  |q 23:7<1971  |1 2015  |2 23  |o 167