Minimally Invasive Knee Replacement

What is it?
Minimally invasive knee replacement accomplishes everything that a traditional knee replacement does, but through a smaller incision (4- to 6-inch incision compared with an 8- to 10-inch incision). With the smaller incision come the potential benefits of a shorter hospital stay, shorter recovery, and a better looking scar.

Better or not?
Although there is no question that an artificial knee can be implanted through a smaller incision, doctors still don't know whether it can be done as well as with the traditional approach.

Which approach?
New techniques for opening the knee may be more important than the length of the incision. Some techniques are "quadriceps-sparing" because they protect the quadriceps tendon and muscle in the front of the thigh. Other techniques called "mid-vastus" and "sub-vastus" make small incisions in the muscle but are also less invasive.

I decided to proceed with this technique for my knee. Is this the best choice for me?
Before you decide to have a minimally invasive knee replacement, get a thorough evaluation from your surgeon. Discuss with him the complications and benefits. Both traditional and minimally invasive knee replacement procedures are technically demanding. They require that the surgeon and operating team have considerable experience. Each patient has an individual therapy. This is a rule in surgery.

Reported benefits of less invasive knee replacement include:Less pain-More cosmetic incisions-Less muscle damage-Rehabilitation is faster-Hospital stays are shorter. For traditional knee replacement, hospital stays average 4 to 5 days. Many patients need extensive rehabilitation afterward. With less-invasive procedures, the hospital stay may be as short as 1 or 2 days. Some patients can go home the day after surgery. Early studies suggest that minimally invasive knee replacement surgery streamlines the recovery process, but the risks and long-term benefits of less-invasive techniques have not yet been documented.

Several early studies of minimally invasive knee replacement surgery have shown some benefits compared with traditional knee replacement, such as less blood loss, shorter hospital stay, and better motion. Other studies have shown a higher rate of complications with minimally invasive knee surgery, including poorer positioning of the knee implants.

The future
More research is needed on the long-term function and durability of minimally invasive knee replacements.
Advocates of minimally invasive knee replacement are working to address concerns about accurate positioning of the knee implants.
Surgeons are also combining the small incision with computer-guided instruments to help improve outcomes. However, the potential benefits, risks, and costs of this have not yet been established.