Minimally invasive technique in total knee arthroplasty - History, tips, tricks and pitfalls

To compare the minimally invasive total knee arthroplasty with standard approach total knee arthroplasty in terms of mean length of post-operative hospital stay. Study Design: Randomized Controlled Trial. Setting: Department of Orthopaedics, Benazir Bhutto Hospital, Rawalpindi. Period: 06 months i.e. from 21st March 2018 to 20th September 2018. Materials and Methods: A total of one hundred (n=100) patients between age 30-80 years who were planned to undergo total knee arthroplasty (TKA) were enrolled and randomly allocated to two groups. The patients in group A were operated through minimally invasive technique and in group B, were operated through standard approach. Outcome was measured in terms of mean length of hospital stay in both groups. Results: Baseline characteristics were comparable in both the groups. In group A, mean length of hospital stay was 4.4±0.64 days while in group B it was 5.6±0.63 days (p=0.001). Similar trend was noted when data was stratified with respect to age, gender, anatomical side and BMI. Conclusion: Minimally invasive TKA resulted in shorter length of hospital stay following when compared with standard approach TKA.

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Selfdynamisable internal fixator Mitkovic in treatment of periprosthetic supracondylar femoral fracture after total knee arthroplasty

Acta chirurgica iugoslavica ◽

10.2298/aci1501049s ◽

2015 ◽

Vol 62 (1) ◽

pp. 49-55

Author(s):

Predrag Stojiljkovic ◽

Milorad Mitkovic ◽

Zoran Golubovic ◽

Ivan Micic ◽

Sasa Milenkovic ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Surgical Treatment ◽

Minimally Invasive ◽

Knee Arthroplasty ◽

Weight Bearing ◽

Internal Fixator ◽

Full Weight Bearing ◽

Invasive Technique ◽

Femur Fractures ◽

Total Knee

Supracondylar periprosthetic femoral fractures after total knee arthroplasty are very rare, but very difficult to treat. They occur most often as a result of low energy trauma (slips and fall) in older patients with present osteoporosis and periprosthetic osteolysis. The treatment of these fractures is very difficult due to reduced biological capacity for healing in most cases. Surgical treatment of these fractures is accompanied by severe complications (prolonged healing, nonunion and disintegration osteosintets material) in 25 to 70% of the cases. The aim of this paper is to present the treatment of supracondylar femur fractures after total knee arthroplasty in men aged 72 with selfdynamisable internal fixator Mitkovic. Surgical treatment of fracture performed on the six day after the injury with minimally invasive surgical technique through two incisions. Verticalization and walking with crutches with non-weight-bearing started the first postoperative day. Patient discharged from hospital fifth postoperative day. Full weight-bearing on the operated leg is allowed after 6 weeks. The patient started a stationary physical therapy 6 weeks after surgery. Postoperative follow-up was 10 months. The fractures healed with an excellent functional result. Application of selfdynamisable internal fixator Mitkovic with minimally invasive technique in the treatment of these complex fractures provides excellent biomechanical conditions for healing.

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