caa a22 4500 60545714X CHVBK 20210128100221.0 cr unu---uuuuu 210128e20150701xx s 000 0 eng 10.1007/s00167-014-2837-4 doi (NATIONALLICENCE)springer-10.1007/s00167-014-2837-4 A meta-analysis of minimally invasive and conventional medial parapatella approaches for primary total knee arthroplasty [Elektronische Daten] [Canfeng Li, Yi Zeng, Bin Shen, Pengde Kang, Jing Yang, Zongke Zhou, Fuxing Pei] 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. Springer-Verlag Berlin Heidelberg, 2014 Minimally invasive approach nationallicence Conventional approach nationallicence Total knee arthroplasty nationallicence Meta-analysis nationallicence Li Canfeng Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China aut Zeng Yi Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China aut Shen Bin Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China aut Kang Pengde Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China aut Yang Jing Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China aut Zhou Zongke Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China aut Pei Fuxing Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/7(2015-07-01), 1971-1985 0942-2056 23:7<1971 2015 23 167 https://doi.org/10.1007/s00167-014-2837-4 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 review-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-014-2837-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Li Canfeng Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China aut NATIONALLICENCE 700 1- Zeng Yi Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China aut NATIONALLICENCE 700 1- Shen Bin Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China aut NATIONALLICENCE 700 1- Kang Pengde Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China aut NATIONALLICENCE 700 1- Yang Jing Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China aut NATIONALLICENCE 700 1- Zhou Zongke Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China aut NATIONALLICENCE 700 1- Pei Fuxing Orthopedic Department, West China Hospital, Sichuan University, Chengdu, China aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/7(2015-07-01), 1971-1985 0942-2056 23:7<1971 2015 23 167