The "mini incision" total knee replacement has recently gained much exposure in the media, and acceptance in the orthopaedic community. Other related terminology includes minimal incision surgery, and minimally invasive surgery. (MIS)
A mini incision as defined by the American Academy of Orthopaedic Surgeons involves a four to six inch length. Most approaches are from the front, and some are slightly to the inside aspect of the knee. More important then the actual length is the treatment of the underlying soft tissues. Extra effort is placed at minimizing irritation to the extensor mechanism/quadriceps muscle. In addition, the synovial joint lining is also disrupted in the least possible manner.
The actual implant components are basically the same. The profile of the instrumentation has been reduced to allow it to be placed through smaller openings. Mobilization of the soft tissue through "movable windows" allows access to the joint through these smaller openings through the use of retractors.
General benefits of less invasive knee replacement surgery may include:
- Less pain.
- Faster recovery through earlier return to function.
- Possibly shorter hospital stay.
Long term benefits of less invasive techniques have not yet been documented or verified to be an improvement over traditional knee replacement surgery. The most important issue is the influence on the predictability, and reliability of component implantation, and the overall long term success. Your individual physician can discuss this concept with you. He will assess whether you are a candidate for the "mini incision" approach, and whether this concept would be applicable or beneficial in your specific situation.