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Minimally invasive total knee arthroplasty: a 10-feature evolutionary approach.
Orthop Clin North Am. 2004 Apr; 35(2):217-26.OC

Abstract

There should not be a revolution to MIS-TKA but rather an evolutionary approach. This includes progressively downsizing incisions and causing less damage to the quadriceps mechanism. Previously,there was an extensive open exposure prolonged patella eversion and dislocation of the tibio-femoral joint. This should be evolved into a VMO muscle split with patella subluxation, retraction but not dislocation, and no gross dislocation of the tibio-femoral joint. Although the present MIS-TKA technique can be difficult and time-consuming, the resulting patient benefits should outweigh the extra effort required. In the future, we may use bone cuts and implantation with computer navigation. Each advance, however, will require new techniques, instrumentation, implants, and careful clinical studies. Caution should be taken by surgeons to avoid revolutionary approaches with existing implants, because they harbor a risk of catastrophic failure.

Authors+Show Affiliations

Bonutti PM
Bonutti Clinic, 1303 Evergreen Avenue, Effingham, IL 62401, USA. drbonutti@bonutticlinic.com
Mont MA
No affiliation info available
Kester MA
No affiliation info available

MeSH

Arthroplasty, Replacement, KneeDermatologic Surgical ProceduresEquipment DesignFemurHumansMinimally Invasive Surgical ProceduresMuscle, SkeletalPatellaSurgery, Computer-AssistedTibia

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15062707

Clinical Trial Links

Effects of Gaseous Cryotherapy on Knee ROM After TKA: A Feasibility Study

Citation

Bonutti, Peter M., et al. "Minimally Invasive Total Knee Arthroplasty: a 10-feature Evolutionary Approach." The Orthopedic Clinics of North America, vol. 35, no. 2, 2004, pp. 217-26.
Bonutti PM, Mont MA, Kester MA. Minimally invasive total knee arthroplasty: a 10-feature evolutionary approach. Orthop Clin North Am. 2004;35(2):217-26.
Bonutti, P. M., Mont, M. A., & Kester, M. A. (2004). Minimally invasive total knee arthroplasty: a 10-feature evolutionary approach. The Orthopedic Clinics of North America, 35(2), 217-26.
Bonutti PM, Mont MA, Kester MA. Minimally Invasive Total Knee Arthroplasty: a 10-feature Evolutionary Approach. Orthop Clin North Am. 2004;35(2):217-26. PubMed PMID: 15062707.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Minimally invasive total knee arthroplasty: a 10-feature evolutionary approach. AU - Bonutti,Peter M, AU - Mont,Michael A, AU - Kester,Mark A, PY - 2004/4/6/pubmed PY - 2004/7/9/medline PY - 2004/4/6/entrez SP - 217 EP - 26 JF - The Orthopedic clinics of North America JO - Orthop Clin North Am VL - 35 IS - 2 N2 - There should not be a revolution to MIS-TKA but rather an evolutionary approach. This includes progressively downsizing incisions and causing less damage to the quadriceps mechanism. Previously,there was an extensive open exposure prolonged patella eversion and dislocation of the tibio-femoral joint. This should be evolved into a VMO muscle split with patella subluxation, retraction but not dislocation, and no gross dislocation of the tibio-femoral joint. Although the present MIS-TKA technique can be difficult and time-consuming, the resulting patient benefits should outweigh the extra effort required. In the future, we may use bone cuts and implantation with computer navigation. Each advance, however, will require new techniques, instrumentation, implants, and careful clinical studies. Caution should be taken by surgeons to avoid revolutionary approaches with existing implants, because they harbor a risk of catastrophic failure. SN - 0030-5898 UR - https://www.unboundmedicine.com/medline/citation/15062707/Minimally_invasive_total_knee_arthroplasty:_a_10_feature_evolutionary_approach_ DB - PRIME DP - Unbound Medicine ER -