Less blood loss + less infection with minimally invasive knee replacements?

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Physical Therapy in San Ramon for Knee

Q: I've been told that with the new minimally invasive knee replacements, there's less blood loss, a lower risk of infection, and faster discharge from the hospital. Is that true?

A: Anyone thinking about having a knee replacement may be wondering whether to stick with the standard surgical procedure or go for the minimally invasive technique. That may surprise you since it would make sense that a smaller incision would be better.

With a minimally invasive approach, there's less disruption of the surrounding soft tissues and less blood loss. But studies have reported in both directions: minimally invasive is better/minimally invasive is not better.

Some studies have shown that there is a benefit with minimally invasive total knee replacement early on in the post-op period. Patients report less pain, faster recovery of knee motion, and shorter stay in the hospital. But there are other studies that fail to show any benefit of the minimally invasive technique compared to the conventional (full incision) approach (early or later on).

Does it just boil down to cosmetics then with a smaller incision? Minimally invasive techniques require additional training on the part of the surgeon. Implant alignment can be a problem for less experienced surgeons. Does the improved external looks outweigh the risk of improper alignment

These are all questions surgeons are searching for answers. More studies are needed before a final recommendation can be made.

Reference: N. Wülker, PhD, MD, et al. A Prospective Randomized Study of Minimally Invasive Total Knee Arthroplasty Compared with Conventional Surgery. In The Journal of Bone and Joint Surgery. July, 2010. Vol. 92-A. No. 7. Pp. 1584-1590.

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