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Functional and radiological outcome after total knee replacement performed with mini-midvastus or conventional arthrotomy: controlled randomised trial


The results of minimally invasive techniques used for total knee replacement are controversial. Despite reported advantages such as faster recovery, there are some concerns regarding component positioning. We compared mini-midvastus versus medial parapatellar arthrotomy with respect to component position and functional results. We included 70 osteoarthritis total knee replacement patients in our study. Patients were randomised for the approach. We recorded Knee Society scores before and after the surgery and radiological component position. Patients were followed up to 12 weeks after the surgery. We found that the mini-midvastus approach was associated with better Knee Society scores six weeks after surgery; after 12 weeks the difference was not statistically significant. We found no difference related to the approach in radiological component position. The mini-midvastus approach is associated with faster recovery and reproduces the same accuracy in component positioning as the medial parapatellar approach.


Les techniques de chirurgie mini-invasives sont controversées dans les prothèses totales du genou. En dépit d’une récupération plus rapide, il est nécessaire de bien observer la position des implants. Nous avons comparé un abord mini-midvastus versus à un abord parapatellaire médian sur les critères position des implants et sur les résultats fonctionnels. Matériel et méthode: 70 approches du genou avec remplacement total ont été étudiés. Les patients ont été randomisés selon la voie d’abord. Le score de la Knee Society et l’étude radiologique ont permis l’évaluation de ces prothèses. Les patients ont été suivis 12 semaines après l’intervention chirurgicale. Résultats: nous avons trouvé que l’abord mini-midvastus était associé à un meilleur score fonctionnel 6 semaines après l’intervention. Après 12 semaines, la différence n’est pas statistiquement significative. Nous n’avons pas trouvé de différence en ce qui concerne la position des implants. En conclusion: l’abord mini-midvastus est associé à une récupération plus rapide et, permet de positionner les implants de façon aussi efficace que lors d’un abord parapatellaire médian.

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Correspondence to Robertinas Juosponis.

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Juosponis, R., Tarasevicius, S., Smailys, A. et al. Functional and radiological outcome after total knee replacement performed with mini-midvastus or conventional arthrotomy: controlled randomised trial. International Orthopaedics (SICOT) 33, 1233–1237 (2009).

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