Research progress of minimally invasive total knee arthroplasty

doi:10.3877/cma.j.issn.1674-134X.2021.03.013

Abstract

Abstract:

With the extension of life expectancy and the aging of the population, the number of patients with knee joint diseases has increasing dramatically. Total knee arthroplasty (TKA) has become the most important and effective method to treat some serious knee joint diseases. The operation can significantly relieve pain, restore joint function and improve the quality of life of patients. Minimally invasive total knee arthroplasty provides a new thought and method for the development of TKA. This paper outlined the definition of minimally invasive TKA(MIS-TKA), describes four approaches of common minimally invasive surgical and analyzes the problems of MIS-TKA in surgical instruments, patient selection, postoperative complications and hospitalization costs. At present, minimally invasive total knee arthroplasty (MIS-TKA) still has many limitations. More evidence is needed to prove the long-term safety and effectiveness of this operation, so as to evaluate the superiority of MIS-TKA more objectively.

Key words: Minimally invasive surgical procedures, Knee joint, Arthroplasty, replacement, knee, Review

Chen Wang, Haoran Yu, Huihui Guo, Xianbo Shang, Sai Ma, Xingyu You, Dechao Cai, Xiao Ma, Haotian Zhang, Ashuai Bian, Wendan Cheng. Research progress of minimally invasive total knee arthroplasty[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2021, 15(03): 339-344.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhgjwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-134X.2021.03.013

https://zhgjwkzz.cma-cmc.com.cn/EN/Y2021/V15/I03/339

Figures/Tables 2

References 40

[1]	Repicci JA, Eberle RW. Minimally invasive surgical technique for unicondylar knee arthroplasty[J]. J South Orthop Assoc, 1999, 8(1): 20-27; discussion 27.
[2]	王林，陈歌．全膝关节置换术手术入路最新研究进展[J]．泸州医学院学报，2016，39(1)：85-87.
[3]	Laskin RS. New techniques and concepts in total knee replacement[J]. Clin Orthop Relat Res, 2003, 11(416): 151-153.
[4]	Mora JP, Scuderi GR. Minimally invasive total knee arthroplasty: does surgical technique actually impact the outcome？[J]. Orthop Clin North Am, 2020, 51(3): 303-315.
[5]	Onggo JR, Onggo JD, Hau R. Comparable outcomes in mini-midvastus versus mini-medial parapatellar approach in total knee arthroplasty: a meta-analysis and systematic review[J]. ANZ J Surg, 2020, 90(5): 840-845.
[6]	Wu Y, Zeng Y, Bao X, et al. Comparison of mini-subvastus approach versus medial parapatellar approach in primary total knee arthroplasty[J]. Int J Surg, 2018, 57: 15-21.
[7]	吴建雄，邓汝林，陈媛，等．经股内侧肌下全膝关节置换术的早期临床疗效观察[J]．重庆医学，2019，48(7)：1201-1203.
[8]	Li Z, Cheng W, Sun L, et al. Mini-subvastus versus medial parapatellar approach for total knee arthroplasty: a prospective randomized controlled study[J]. Int Orthop, 2018, 42(3): 543-549.
[9]	Kazarian GS, Siow MY, Chen AF, et al. Comparison of quadriceps-sparing and medial parapatellar approaches in total knee arthroplasty: a meta-analysis of randomized controlled trials[J]. J Arthroplasty, 2018, 33(1): 277-283.
[10]	Yuan FZ, Jy Z, Jiang D, et al. Quadriceps-sparing versus traditional medial parapatellar approaches for total knee arthroplasty: a meta-analysis[J]. BMC Musculoskelet Disord, 2019, 20(1): 117-126.
[11]	杨伟毅，潘建科，张智勉，等．改良股四头肌保留入路全膝关节置换术的临床研究[J]．现代医院，2017，17(11)：1657-1660.
[12]	Tzatzairis T, Fiska A, Ververidis A, et al. Minimally invasive versus conventional approaches in total knee replacement/arthroplasty: a review of the literature[J]. J Orthop, 2018, 15(2): 459-466.
[13]	Shih KS, Lin CC, Lu HL, et al. Patient-specific instrumentation improves functional kinematics of minimally-invasive total knee replacements as revealed by computerized 3D fluoroscopy[J/OL]. Comput Methods Programs Biomed, 2020, 188: 105250. doi：10.1016/j.cmpb.2019.105250.
[14]	Picard F, Deakin A, Balasubramanian N, et al. Minimally invasive total knee replacement: techniques and results[J]. Eur J Orthop Surg Traumatol, 2018, 28(5): 781-791.
[15]	Dalton DM, Burke TP, Kelly EG, et al. Quantitative analysis of technological innovation in knee arthroplasty: using patent and publication metrics to identify developments and trends[J]. J Arthroplasty, 2016, 31(6): 1366-1372.
[16]	Pinsornsak P, Harnroongroj T. Comparison of accuracy between side-cutting instruments and front-cutting instruments in minimally invasive total knee arthroplasty[J]. J Med Assoc Thai, 2016, 99(11): 1185-1191.
[17]	Ang CL, Yeo SJ. Quality of cementation in conventional versus minimally invasive total knee arthroplasty[J]. J Orthop Surg (Hong Kong), 2016, 24(1): 7-11.
[18]	Iamthanaporn K, Yuenyongviwat V, Laohawiriyakamol T, et al. Accuracy of medial-side cutting guide compared to anterior cutting guide in distal femoral osteotomy of total knee arthroplasty[J]. J Clin Orthop Trauma, 2019, 10(1): 87-90.
[19]	朱超，王斌，殷建，等．个性化截骨工具辅助下人工全膝关节置换与传统人工全膝关节置换手术精确度及临床疗效比较[J]．生物骨科材料与临床研究，2019，16(3)：54-58.
[20]	刘浩，吴博，郑清源，等．个性化股骨远端截骨导向器与传统手术工具在微创入路膝关节置换术中的应用对比[J]．中华保健医学杂志，2018，20(3)：198-202.
[21]	Alcelik IA, Blomfield MI, Diana G, et al. A comparison of short-term outcomes of minimally invasive computer-assisted vs minimally invasive conventional instrumentation for primary total knee arthroplasty: a systematic review and meta-analysis[J]. J Arthroplasty, 2016, 31(2): 410-418.
[22]	Khuangsirikul S, Lekkreusuwan K, Chotanaphuti T. 10-Year patient satisfaction compared between computer-assisted navigation and conventional techniques in minimally invasive surgery total knee arthroplasty[J]. Comput Assist Surg (Abingdon), 2016, 21(1): 172-175.
[23]	Thiengwittayaporn S, Fusakul Y, Kangkano N, et al. Hand-held navigation May improve accuracy in minimally invasive total knee arthroplasty: a prospective randomized controlled trial[J]. Int Orthop, 2016, 40(1): 51-57.
[24]	Zahn RK, Graef F, Conrad JL, et al. Accuracy of tibial positioning in the frontal plane: a prospective study comparing conventional and innovative techniques in total knee arthroplasty[J]. Arch Orthop Trauma Surg, 2020, 140(6): 793-800.
[25]	Yoo JH, Park SH, Han CD, et al. Radiologic outcomes according to varus deformity in minimally invasive surgery total knee arthroplasty[J]. Yonsei Med J, 2016, 57(1): 225-231.
[26]	Yoo JH, Oh HC, Park SH, et al. Does obesity affect clinical and radiological outcomes in minimally invasive total knee arthroplasty? Minimum 5-Year follow-up of minimally invasive TKA in obese patients[J]. Clin Orthop Surg, 2018, 10(3): 315-321.
[27]	陈述祥，董锐，林汉生．微创人工全膝关节置换与传统技术临床疗效比较的Meta分析[J]．中国矫形外科杂志，2011，19(21)：1777-1780.
[28]	Unwin O, Hassaballa M, Murray J, et al. Minimally invasive surgery (MIS) for total knee replacement; medium term results with minimum five year follow-up[J]. Knee, 2017, 24(2): 454-459.
[29]	Benotti PN, Still CD, Craig WG, et al. Surgical weight-loss to improve functional status trajectories following total knee arthroplasty: SWIFT trial: rationale, design, and methods[J]. Contemp Clin Trials, 2018, 69: 1-9.
[30]	Meftah M, Jhurani A, Bhat JA, et al. The effect of patellar replacement technique on patellofemoral complications and anterior knee pain[J/OL]. J Arthroplasty, 2012, 27(6): 1075-80.e1.doi：10.1016/j.arth.2011.10.006.
[31]	Reid MJ, Booth G, Khan RJ, et al. Patellar eversion during total knee replacement: a prospective, randomized trial[J]. J Bone Joint Surg Am, 2014, 96(3): 207-213.
[32]	Zan P, Wu Z, Yu X, et al. The effect of patella eversion on clinical outcome measures in simultaneous bilateral total knee arthroplasty: a prospective randomized controlled trial[J]. J Arthroplasty, 2016, 31(3): 637-640.
[33]	黄远章，张民，牛金龙，等．全膝关节置换术中髌骨翻转与髌骨侧方移位的临床疗效比较[J/CD]．中华临床医师杂志(电子版)，2016，40(14)：2197-2200.
[34]	Huang AB, Wang HJ, Yu JK, et al. Optimal patellar alignment with minimally invasive approaches in total knee arthroplasty after a minimum five year follow-up[J]. Int Orthop, 2016, 40(3): 487-492.
[35]	Ripollés-Melchor J, Abad-Motos A, Logroño-Egea M, et al. Postoperative outcomes within enhanced recovery after surgery protocol in elective total hip and knee arthroplasty. POWER.2 study: study protocol for a prospective, multicentre, observational cohort study[J]. Turk J Anaesthesiol Reanim, 2019, 47(3): 179-186.
[36]	郭鹏程，徐熙鹏，李大伟，等．股肌下结合微斜切入路与经股肌入路全膝关节置换术后早期血清学标志物水平差异[J]．中华骨与关节外科杂志，2020，13(3)：230-235.
[37]	Yen SH, Lin PC, Chen B, et al. Topical tranexamic acid reduces blood loss in minimally invasive total knee arthroplasty receiving rivaroxaban[J/OL]. Biomed Res Int, 2017: 9105645. doi：10.1155/2017/9105645.
[38]	Wang JW, Chen B, Lin PC, et al. The efficacy of combined use of rivaroxaban and tranexamic acid on blood conservation in minimally invasive total knee arthroplasty a double-blind randomized, controlled trial[J]. J Arthroplasty, 2017, 32(3): 801-806.
[39]	王荣强．MIS-TKA与TKA治疗膝关节骨性关节炎的效果分析[J]．河南医学高等专科学校学报，2019，31(4)：446-448.
[40]	King JC, Manner PA, Stamper DL, et al. Is minimally invasive total knee arthroplasty associated with lower costs than traditional TKA？[J]. Clin Orthop Relat Res, 2011, 469(6): 1716-1720.

	MPA	MMA	MSA	QSA
手术入路特点	切开部分股四头肌肌腱，外翻髌骨	自股内侧肌边缘向下沿髌韧带内侧缘切开	利用股内侧肌下间隙，不外翻髌骨	利用股内侧肌肌间隙，不外翻髌骨
优势	难度小，易推广	难度适中，损伤小，术中视野较好	损伤小，恢复较快，并发症较少	损伤最小，术后恢复快
局限性	损伤伸膝装置，恢复慢	手术时间延长	难度大，对患者的选择较高	难度大，并发症风险高

	MPA	MMA	MSA	QSA
手术入路特点	切开部分股四头肌肌腱，外翻髌骨	自股内侧肌边缘向下沿髌韧带内侧缘切开	利用股内侧肌下间隙，不外翻髌骨	利用股内侧肌肌间隙，不外翻髌骨
优势	难度小，易推广	难度适中，损伤小，术中视野较好	损伤小，恢复较快，并发症较少	损伤最小，术后恢复快
局限性	损伤伸膝装置，恢复慢	手术时间延长	难度大，对患者的选择较高	难度大，并发症风险高

Please choose a citation manager

Content to export