Short Term Result of Minimally Invasive Total Knee Arthroplasty with Mini-Midvastus Approach

Ju Hyung Yoo; Han Kook Yoon; Chang Dong Han; Hang Seob Yoon; Yun Tae Lee; Hyun Cheol Oh; Seung Yong Sung; Hyun Soo Chung

doi:10.4055/jkoa.2009.44.2.186

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Yoo, Yoon, Han, Yoon, Lee, Oh, Sung, and Chung: Short Term Result of Minimally Invasive Total Knee Arthroplasty with Mini-Midvastus Approach

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2009; 44(2): 186-191.

Published online: 30 April 2009

DOI: https://doi.org/10.4055/jkoa.2009.44.2.186

Short Term Result of Minimally Invasive Total Knee Arthroplasty with Mini-Midvastus Approach

Ju Hyung Yoo, M.D., Han Kook Yoon, M.D., Chang Dong Han, M.D.^*, Hang Seob Yoon, M.D.^*, Yun Tae Lee, M.D., Hyun Cheol Oh, M.D., Seung Yong Sung, M.D., Hyun Soo Chung, M.D.

Department of Orthopaedic Surgery, National Health Insurance Corporation Ilsan Hospital, Ilsan, Korea.

^*Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea.

Address reprint requests to Han Kook Yoon, M.D. Department of Orthopaedic Surgery, National Health Insurance Corporation Ilsan Hospital, 1232 Baekseok-dong, Ilsan-gu, Goyang 411-360, Korea. Tel: +82.31-900-0540, Fax: +82.31-900-0343, hangugi@gmail.com

Abstract

Purpose

To investigate the effectiveness of minimally invasive total knee arthroplasty using the mini-midvastus approach through analyzing the short-term clinical outcomes.

Materials and Methods

Seventy-seven consecutive total knee arthroplasties were performed with the mini-midvastus surgical technique from August 2005 to February 2006 and were followed for more than 1 year after the procedure. All operations were performed with the Nexgen LPS-flex total knee system using a MIS quad-sparing instrument. The evaluation included preoperative and postoperative clinical data, surgical and radiological outcomes.

Results

The length of skin incision was average 8.4±0.6 cm and the operation time was average 95.5±15.7 minutes. The blood loss was average 727.5±315.5 cc. The tibial component alignment angles averaged 0.2±1.3° varus and the tibiofemoral angles averaged 5.8±1.8°. The mean ROM and the mean HSS score was 117±10° and 120±11°, 88.9±7.1 and 96.2±4.5 at eight weeks and one year after surgery respectively.

Conclusion

If proper surgical procedures are performed using the appropriate surgical instruments, minimally invasive total knee arthroplasty with the assistance of the mini-midvastus approach, can result in good clinical outcomes and alignment of the implants.

Keywords: Knee, Total knee arthroplasty, Minimal invasive, Mini-midvastus approach

Figures and Tables

Fig. 1

The arthrotomy started from the supero-medial border of the patella followed along the medial border of the patella, and finished at the medial border of the tibial tuberosity, and added 1.5 cm to the incision parallel to the direction of the vastus medialis oblique muscle fiber to the proximal direction.

Fig. 2

The length of the postoperative scar was measured with the knee in full extension after wound closure.

Fig. 3

The length of the split vastus medialis was measured from the superomedial corner of the patella to the upper limit of the split vastus medialis.

Table 1

Patient Demographics

^*BMI, body mass index; ^†Pre op, pre-operative; ^‡OA, osteoarthritis; ^§RA, rheumatoid arthritis; ^∥ROM, range of motion; ^¶HSS, hospital for special surgery.

Table 2

Postoperative Data

^*Post op, postoperative; ^†ROM, range of motion; ^‡HSS, hospital for special surgery.

Table 3

Postoperative Radiological Data

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