A study at the 19th Annual Meeting of the American Association of Hip and Knee surgeons in Dallas, Texas, comparing the results of a MIS or minimally invasive total knee to a more standard smaller incision total knee was presented. Dr. Nestor presented results of a prospective randomized double blinded study that compared 27 patients undergoing bilateral knee replacement. One knee was randomized to undergo a minimally invasive approach while the other knee had a standard approach total knee. The skin incisions on both sides were the same size, therefore the patient, the staff, and the therapist did not know which side had a smaller exposure underneath the skin. Comparing the results, there was no difference between the two knees at 6 weeks or 12 weeks postoperatively. There was a slightly higher malalignment noted in the minimally invasive approach. After discussion, it was concluded that the size of the soft tissue exposure underneath the skin has very little influence on the result of total knee replacement. All surgeons generally use a smaller skin incision and therefore smaller approach than was utilized 15 years ago, but attempts to use unique cutting guides via a medial approach and/or limited exposure offers no clinical benefit, based on the bulk of studies presented to date in the literature.
