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Review of Minimally Invasive Total Knee Replacement

Total knee replacement (TKR) can be done now using a minimally invasive (MIS) approach. A smaller incision is made and in some cases, cutting into the quadriceps muscle is avoided altogether. This is called a MIS quadriceps-sparing TKR.

In this report Dr. Alfred J. Tria, Jr. offers the benefit of his expertise. He has used this method with 450 patients. He reviews the pros and cons of the quadriceps-sparing TKR. The biggest problem surgeons run into with this operation is the limited visibility. With the smaller incision, the surgeon doesn’t see inside the entire joint.

Getting the implant in place with the proper alignment is the greatest challenge. New technology with electromagnetic navigation may reduce these kinds of problems. The surgeon is able to use the navigation system to see the position of the implant and the surgical instruments.

Early results of MIS quadriceps-sparing TKR are now being published. Two-year data shows patients have less pain, less time in the hospital, and more range of motion when compared to patients with the standard TKR.

Long-term results aren't available yet. For now it looks like the best candidates for this operation are patients younger than 80 years old who weigh less than 225 pounds and have at least 105 degrees of total knee motion. Patients with minimal deformity who are not overweight and who have more range of motion (125 degrees) have the best results so far.

References: Alfred J. Tria, Jr, MD. Exploring the Depths of Minimally Invasive Quadriceps-Sparing Total Knee Arthroplasty. In Orthopedics. March 2006. Vol. 29. No. 3. Pp. 214-215.

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