Minimally Invasive Lateral Approach to Total Knee Arthroplasty

Abstract

Standard anterior approaches to total knee arthroplasties have led to both excellent short- and long-term results with overall survivorship rates over 95% at 10 years and longer in multiple series.1, 2, 3, 4, 5, 6, 7 However, when evaluating specific patient-related functional outcomes, it appears that only 20% to 40% of patients are completely satisfied with the results of total knee arthroplasty and that the arthroplasty might limit a variety of functional activities.8, 9, 10 Several authors have described a discrepancy between surgeons’ perceptions and the patients’ perceptions of outcomes following total knee arthroplasty. In a study by Dickstein et al.,9, nearly one-third of respondents felt some dissatisfaction with their surgery when evaluated at both 6 and 12 months. Bullens et al.8 concluded “that surgeons are more satisfied than patients after total knee arthroplasty.” In another study of the functional limits of total knee arthroplasty patients with high Knee Society objective knee scores (greater than 90 points) at one year, only 35% of these patients felt that they had no limitations with activity.11 This finding was even more noticeable in younger patients as only 13% patients under the age of 60 years believed they had no activity limitations.12 The authors believe that the reasons for these less than favorable results are multifactorial, but may in part have to do with the conventional anterior surgical approach while performing traditional total knee arthroplasties.