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Minimally invasive small incision surgical technique for unicompartmental knee arthroplasty

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Abstract

Purpose

It is always a challenge for orthopaedic surgeons to minimise surgical incisions while ensuring excellent surgical results. We propose the minimally invasive small incision (MISI) technique and an extramedullary positioning technique in the unicompartmental knee arthroplasty (UKA) surgery. This study aimed to clarify the early postoperative clinical outcomes and component alignment between MISI and conventional minimally invasive surgical (MIS) techniques.

Methods

We prospectively enrolled 60 patients who underwent MISI-UKA and 60 patients who underwent MIS-UKA as controls. Clinical parameters include the time of straight leg raising, postoperative walking time with walker assistance, hospital stay, Numerical Rating Scale (NRS) pain score and Knee Society Score (KSS). The postoperative components and lower extremity alignment were compared between the two groups with radiographic image measurement.

Results

The MISI group obtained a smaller incision during knee extension (P < 0.001) but a longer tourniquet usage time than the MIS group. The MISI group lost less blood (P < 0.001). The MISI group achieved straight leg raising and walking with aid earlier after surgery, with a shorter hospital stay than the MIS group (P < 0.001). Range of motion (ROM), NRS and KSS scores revealed no significant difference between the two groups in six months postoperative follow-up (P > 0.05). Radiographic measurement results between the two groups revealed no statistical difference (P > 0.05)

Conclusion

The MISI-UKA could achieve faster earlier recovery after surgery and shorter hospital stays without compromising the principles of proper prosthesis position and limb alignment compared with the conventional MIS-UKA.

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Data availability

All of the data are available in contact with the correspondence author.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China

    Juncheng Ge & Wanshou Guo

  2. Department of Orthopaedic Surgery, China-Japan Friendship Hospital, Beijing, China

    Juncheng Ge, Wanshou Guo, Nianfei Zhang, Changquan Liu & Qidong Zhang

  3. Department of Orthopaedic Surgery, University Paris East (UPEC), Hôpital Henri Mondor, Creteil, France

    Philippe Hernigou

  4. China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China

    Changquan Liu

Authors
  1. Juncheng Ge
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  2. Philippe Hernigou
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  3. Wanshou Guo
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  4. Nianfei Zhang
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  5. Changquan Liu
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  6. Qidong Zhang
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Contributions

Juncheng Ge and Wanshou Guo designed the study. Qidong Zhang and Wanshou Guo operated the UKA procedure. Juncheng Ge and Changquan Liu did the data collection. Juncheng Ge and Nianfei Zhang did the data analysis. Juncheng Ge wrote the article. Philippe Hernigou, Nianfei Zhang and Wanshou Guo revised the article. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Philippe Hernigou or Wanshou Guo.

Ethics declarations

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the institutional review board of China-Japan Friendship Hospital (approval number 2022–KY-182).

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Informed consent was obtained from all individual participants included in the study.

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All authors had consented to the submission of the article to the journal.

Competing interests

The authors declare no competing interests.

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Ge, J., Hernigou, P., Guo, W. et al. Minimally invasive small incision surgical technique for unicompartmental knee arthroplasty. International Orthopaedics (SICOT) 47, 2717–2725 (2023). https://doi.org/10.1007/s00264-023-05908-5

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  • DOI: https://doi.org/10.1007/s00264-023-05908-5

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