| 摘要 |
Minimally invasive total knee arthroplasty (MIS TKA) was first reported in 2003 by
Tria and Coon. Seventy MIS TKAs with a subvastus approach were completed over
9 months. They reported 50% less blood loss, and 20% more range of motion at first
OPD visit. The alignment of the prosthetic components was the same as those from
standard total knee arthroplasty (S TKA). Most reports in the literature later
showed higher Knee Society scores, greater flexion, earlier straight leg raising in
MIS TKA in short term follow up, but also more complications and poorer
component alignment. The results of a systematic review and meta-analyses were
similar although the number of cases was limited.
Most of the reports on MIS-TKA are from surgeons with much experience in
traditional S TKA. Even for these skilled surgeons there is a significant learning
curve. Thus, it may not be appropriate for all surgeons to lightly adopt the MIS
TKA technique and expect similar results. MIS TKA for some particular surgeons,
however, may provide more advantages than disadvantages. The ultimate goal for
MIS TKA is a painless, well functioning knee with good longevity. As proper
alignment of prosthetic components is the key to achieving this goal, MIS TKA
should not compromise component alignment. A gradual transition from traditional
S TKA to MIS TKA with selected patients is recommended. Even a high-volume,
experienced surgeon should perform MIS TKA only in selected cases after
appropriate discussion with patients about the advantages and disadvantages of this
approach. |
